Individual provider Active NPI

Jacob Leigh, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Cedarhurst, NY
National Provider Identifier
1134576010
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
006965 Issued in NY
Practice address
650 Central Ave Ste C
Cedarhurst, NY 11516-2301
Phone
(516) 295-3338
NPI assigned
May 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X N006965 NY
Foot & Ankle Surgery Podiatrist 213ES0103X 006965 NY Primary

Addresses

Primary practice location

650 Central Ave Ste C
Cedarhurst, NY 11516-2301

Mailing address

650 Central Ave Ste C
Cedarhurst, NY 11516-2301

Other practice location 1

327 Beach 19th St
Far Rockaway, NY 11691-4423
Phone (718) 869-7000

Other identifiers 1

IdentifierTypeStateIssuer
N006965OtherNYNYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190808000173 NY Practitioner - Podiatry 4082941497 Reassigns benefits to 3 organizations
Practice locations: Cedarhurst, NY; Far Rockaway, NY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kanghan Medical Services, P.C.Group PAC ID 6305862715, 3 clinicians
Atm Foot Care, PLLCGroup PAC ID 0941461495, 2 clinicians

Practice addresses (Care Compare)

19214 Northern Blvd
2D
Flushing, NY 11358-2955
Phone (718) 762-3240

327 Beach 19TH St
Far Rockaway, NY 11691-4423
Phone (516) 295-3338

650 Central Ave
Suite C
Cedarhurst, NY 11516-2301
Phone (516) 295-3338

8708 Justice Ave
Suite CX
Elmhurst, NY 11373-8715
Phone (718) 446-4230

Hospital & facility affiliations

  • St John'S Episcopal Hospital at South Shore Hospital, Far Rockaway, NY, CCN 330395

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue34
Removal of skin lesions15
Removal of nail tissue479
Removal or shaving of skin growth53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006965NYMDFoot & Ankle Surgery Podiatrist
N006965NYMDFoot & Ankle Surgery Podiatrist

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Atm Foot Care, PLLC Foot & Ankle Surgery CurrentSince Oct 6, 2019 Accepting new patients
Veritas Podiatry PLLC Foot & Ankle Surgery CurrentSince Nov 24, 2025 Accepting new patients
St John'S Medical Services PC CurrentSince Jul 1, 2019 Accepting new patients

Locations

650 Central Ave
Ste C
Cedarhurst, NY 11516
Phone (225) 333-8618

8708 Justice Ave
Ste Cx
Elmhurst, NY 11373
Phone (718) 446-4230

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

Networks

  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAACBD/Endpoint/FAACBD
  • FHIR API: https://api.platform.athenahealth.com/14448/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/FAACBD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1134576010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 CENTRAL AVE STE C",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 CENTRAL AVE STE C",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162301",
            "telephone_number": "516-295-3338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 Beach 19th St",
            "address_purpose": "LOCATION",
            "city": "Far Rockaway",
            "state": "NY",
            "postal_code": "116914423",
            "country_code": "US",
            "telephone_number": "718-869-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIGH",
        "first_name": "JACOB",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-19",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006965",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "006965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "N006965",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

Verify at the official NPI Registry.