Individual provider Active NPI

Madeline Wallis Lebar, MD

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1184250136
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
74300 Issued in TN
Practice address
420 Monroe Ave Apt 1303
Memphis, TN 38103-3252
Phone
(804) 263-4773
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 74300 TN Primary

Addresses

Primary practice location

420 Monroe Ave Apt 1303
Memphis, TN 38103-3252

Mailing address

420 Monroe Ave Apt 1303
Memphis, TN 38103-3252
Phone (804) 263-4773

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125002974 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1254723265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
181158CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Irvine PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1184250136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MONROE AVE APT 1303",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033252",
            "telephone_number": "804-263-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 MONROE AVE APT 1303",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033252",
            "telephone_number": "804-263-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBAR",
        "first_name": "MADELINE",
        "middle_name": "WALLIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "74300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.