NPIMap

Individual provider Active NPI

Katelyn Ann Leopold, M.D.

  • Family Medicine Physician
  • Ottawa, OH
National Provider Identifier
1174785133
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.096474 Issued in OH
Practice address
1740 N Perry St Ste a
Ottawa, OH 45875-1173
Phone
(419) 523-0012
Fax
(419) 523-3416
NPI assigned
Jun 30, 2008
Last updated
Jun 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.096474 OH Primary

Addresses

Primary practice location

1740 N Perry St Ste a
Ottawa, OH 45875-1173

Mailing address

1740 N Perry St Ste a
Ottawa, OH 45875-1173

Other identifiers 2

IdentifierTypeStateIssuer
0050083MedicaidOH
H011001OtherOHMEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000412 OH Practitioner - Family Practice 7315116084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Cincinnati College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lima, LLCGroup PAC ID 3375607351, 54 clinicians

Practice addresses (Care Compare)

770 W High St
Suite 450
Lima, OH 45801-3962
Phone (419) 996-5633

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.096474OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blanchard Valley Regional Health Center Family Medicine Current Accepting new patients
Mercy Health Physicians Lima, LLC Family Medicine CurrentSince May 14, 2022 Accepting new patients
Mercy Health Physicians Lima Specialty Care LLC CurrentSince May 20, 2023 Accepting new patients
Blanchard Valley Regional Health Center CurrentSince Mar 1, 2020 Accepting new patients
Blanchard Valley Regional Health Center Family Medicine CurrentSince Mar 1, 2020 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

100 Progressive Dr
Columbus Grove, OH 45830
Phone (419) 659-6010

1900 S Main St
Findlay, OH 45840
Phone (419) 423-4500

3949 N Main St
Ste B
Findlay, OH 45840
Phone (419) 423-3888

3224 Jarvis Rd
Lima, OH 45807
Phone (419) 996-5757

770 W High St
Ste 450
Lima, OH 45801
Phone (419) 996-5069

830 W High St
Ste 390
Lima, OH 45801
Phone (419) 995-4960

1740 N Perry St
Ste A
Ottawa, OH 45875
Phone (419) 523-0012

Interoperability endpoints

  • Direct secure messaging: kleopold11141@direct.bsmhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1174785133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 N PERRY ST STE A",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458751173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 N PERRY ST STE A",
            "city": "OTTAWA",
            "state": "OH",
            "postal_code": "458751173",
            "telephone_number": "419-523-0012",
            "fax_number": "419-523-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEOPOLD",
        "first_name": "KATELYN",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.096474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050083",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "H011001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottawa, OH

Sources for this page

Verify at the official NPI Registry.