Leanne M Liddicoat, O.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

11076T Issued in CA

Practice address

114 N Sunrise Ave
Suite C2
Roseville, CA 95661-2916

Phone

(916) 786-2212

Fax

(916) 786-2393

NPI assigned

Sep 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fyidoctors of California IncGroup PAC ID 3577961572, 21 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fyidoctors of California, Inc.

  • Optometrist
  • Roseville, CA
  • NPI 1437718418
  Medicare reassignment Care Compare group NPD
• Aaron E Lech Optometry a

  • Optometrist
  • Roseville, CA
  • NPI 1396046850
  Medicare reassignment NPD
• North Lake Eyecare Optometry

  • Optometrist
  • Tahoe City, CA
  • NPI 1447580360
  NPD (past)

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1154413797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N SUNRISE AVE",
            "address_2": "SUITE C2",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612916",
            "telephone_number": "916-786-2212",
            "fax_number": "916-786-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N SUNRISE AVE",
            "address_2": "SUITE C2",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612916",
            "telephone_number": "916-786-2212",
            "fax_number": "916-786-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDICOAT",
        "first_name": "LEANNE",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "CA",
            "license": "11076T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gisselle Leyva Alonso
• Angelica Leyva
• Carolyn Li, MD
• Jason Noel Li, DO
• Ziqian Li, MS, RDN, CDCES, CNSC
• Lien Lac LMFT
• Rebecca Lierly, M.A.
• Life Source, Inc.
• Lifeboat14Llc
• Lifespark Health and Wellness Nursing PC

• Vision Therapy Optometrist in Roseville, CA
• Providers in Roseville, CA by specialty
• Vision Therapy Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.