Leigh Mark Ettinger, MD, MS

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

221725-01 Issued in NY

Practice address

301 Manchester Rd Ste 105
Poughkeepsie, NY 12603-2895

Phone

(845) 452-1700

NPI assigned

Jun 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Pediatrics

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• The Childrens Medical Group

  • Pediatrics Physician
  • Poughkeepsie, NY
  • NPI 1841224508
  NPD (past)
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Psychologist
  • Red Bank, NJ
  • NPI 1609593722
  NPD (past)

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1194765859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MANCHESTER RD STE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032895",
            "telephone_number": "458-452-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MANCHESTER RD STE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126032895",
            "telephone_number": "845-452-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "LEIGH",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NJ",
            "license": "25MA07761200",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "221725-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Estrada Gomez
• Janine E Estupinan, LCSW-R
• Marise Etienne, LPN
• Shira Etshalom, NP-C
• Britney Ann Ettinger
• Bartley J Ettori, LCSW
• Ann Lorraine Evans, RN
• Jade Evans, LPN
• Amanda Ewanciw, MHC
• Eye Sparkle Optical Corporation

• Pediatrics Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.