Korey Leafblad, D.O.
Individual provider Active NPI Diagnostic Radiology Physician · West Point, NY
NPI 1134515372 · NPPES record last updated Jul 27, 2022
Key facts
- NPI
- 1134515372
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 1529 (NE)
- Practice address
- 900 Washington Rd
West Point, NY 10996-1109 - Phone
- (845) 938-7992
- NPI assigned
- Apr 14, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Rocky Vista University College of Osteopathic Med, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 299
Salt Lake City, UT 84110
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221005000171 | NY | Practitioner - Diagnostic Radiology | 8123438603 | Reassigns benefits to 3 organizations |
| I20260529003778 | UT | Practitioner - Diagnostic Radiology | 8123438603 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1529 | NE | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union Avenue Open MRI LLC | Current |
Accepting new patients | |
| Tra-Minw P S | Current |
Accepting new patients | |
| Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 1529 | NE | Yes |
| General Practice Physician | 208D00000X | 1529 | NE |
Addresses
Primary practice location
900 Washington Rd
West Point, NY 10996-1109
Mailing address
900 Washington Rd
West Point, NY 10996-1109
Other practice location 1
8901 Rockville Pike
Bethesda, MD 20889-0001
Phone (309) 295-4000
Other providers in West Point, NY
- Artem Lapin
- Lucille Catherine Larney
- Jamie Laube
- Sharail Smith Lawrence
- Louie L Le
- Rachel Ann Leahy
- Benjamin Edward Leary
- Brent Lee Lechner
- Kathleen Mary Lehault
- Veronica Lincoln
All providers in West Point, NY · Diagnostic Radiology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.