Active NPI
Leeah Sue Reidenbach, DO
- Pediatrics Physician
- Auburn, IN
National Provider Identifier
1174228613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 02009001A
- Practice address
- 1314 E 7TH St Ste 101
Auburn, IN 46706-2533 - Phone
- (260) 925-3500
- Fax
- (260) 925-3195
- NPI assigned
- Apr 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 02009001A | IN | Primary |
Addresses
Primary practice location
1314 E 7TH St Ste 101
Auburn, IN 46706-2533
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230523001046 | NC | Order and Referring Only - Pediatric Medicine | 7810353596 |
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11109 Parkview Plaza Dr
Fort Wayne, IN 46845-1701
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02009001A | IN | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787184000000",
"number": "1174228613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1314 E 7TH ST STE 101",
"city": "AUBURN",
"state": "IN",
"postal_code": "467062533",
"telephone_number": "260-925-3500",
"fax_number": "260-925-3195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIDENBACH",
"first_name": "LEEAH",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-03",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "02009001A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, IN
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- Paul H Rexroth, MD
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.