Individual provider Active NPI

Jeffrey Jack Leya, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Mason City, IA
National Provider Identifier
1124479449
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Mercyone Family Medicine Residency Program
1010 4TH St SW Ste 240
Mason City, IA 50401
Phone
(641) 428-7779
NPI assigned
Jun 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IA Primary

Addresses

Primary practice location

Mercyone Family Medicine Residency Program
1010 4TH St SW Ste 240
Mason City, IA 50401

Mailing address

2160 S 1St Ave
BLDG 120, Room 220
Maywood, IL 60153

Other practice location 1

1407 Geneva Rd
Ann Arbor, MI 48103-4487
Phone (734) 936-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250613003329 IA Order and Referring Only - Family PracticePractitioner - Family Practice 8224549563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1124479449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "BLDG 120, ROOM 220",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MERCYONE FAMILY MEDICINE RESIDENCY PROGRAM",
            "address_2": "1010 4TH ST SW STE 240",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "50401",
            "telephone_number": "641-428-7779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1407 Geneva Rd",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481034487",
            "country_code": "US",
            "telephone_number": "734-936-4000",
            "fax_number": "915-742-3238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEYA",
        "first_name": "JEFFREY",
        "middle_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.