Individual provider Active NPI

Lisa L Leininger, PSYD

  • Psychologist
  • Marshall, MI
National Provider Identifier
1174623995
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301007567 Issued in MI
Practice address
15209 W Michigan Ave
Marshall, MI 49068-9570
Phone
(269) 781-9119
Fax
(269) 789-4347
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301007567 MI Primary

Addresses

Primary practice location

15209 W Michigan Ave
Marshall, MI 49068-9570

Mailing address

15209 W Michigan Ave
Marshall, MI 49068-9570
Phone (269) 781-9119

Other identifiers 1

IdentifierTypeStateIssuer
7509107630OtherMIBCBS OF MI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000189 MI Practitioner - Clinical Psychologist 0244407658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Michigan University School of MedicineGroup PAC ID 7517113954, 76 clinicians

Practice addresses (Care Compare)

1717 Shaffer St
Suite 10
Kalamazoo, MI 49048-1647
Phone (269) 337-6373

Merit-based Incentive Payment System (MIPS)

Final score
97.1 of 100Reported as group
Quality
85.82
Promoting interoperability
100
Improvement activities
40
Cost
77.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301007567MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University Kalamazoo Center for Medical Studies CurrentSince Nov 2, 2020 Accepting new patients
Western Michigan University School of Medicine CurrentSince Nov 2, 2020 Accepting new patients

Locations

1000 Oakland Dr
Kalamazoo, MI 49008
Phone (269) 337-4347

1717 Shaffer St
Ste 10
Kalamazoo, MI 49048
Phone (269) 337-6200

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1174623995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15209 W MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689570",
            "telephone_number": "269-781-9119",
            "fax_number": "269-789-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15209 W MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490689570",
            "telephone_number": "269-781-9119",
            "fax_number": "269-789-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEININGER",
        "first_name": "LISA",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301007567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "7509107630",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.