Individual provider Active NPI

John P. Leichner, MD

  • Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1225072192
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD023910E Issued in PA
Practice address
10900 Knights Rd
Philadelphia, PA 19154-4210
Phone
(215) 632-0693
Fax
(215) 637-1681
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD023910E PA
Surgery Physician 208600000X MD023910E PA Primary

Addresses

Primary practice location

10900 Knights Rd
Philadelphia, PA 19154-4210

Mailing address

10900 Knights Rd
Philadelphia, PA 19154-4210
Phone (215) 632-0693

Other identifiers 1

IdentifierTypeStateIssuer
0007187560005MedicaidPA

Other names 1

  • Dr. John P. Leichner Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050215000417 PA Practitioner - General PracticePractitioner - General SurgeryPractitioner - Family PracticePractitioner - Peripheral Vascular DiseasePractitioner - Vascular Surgery 2567414832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: General Surgery, Peripheral Vascular Disease, Vascular Surgery
Education
George Washington University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zoya Berenson MD PC-Greater NE Medical GroupGroup PAC ID 6709858012, 4 clinicians
Eastern Pennsylvania Physician Alliance, LLCGroup PAC ID 8325478662, 112 clinicians

Practice addresses (Care Compare)

2000 Grant Ave
Suite 201
Philadelphia, PA 19115-4378
Phone (215) 464-6104

4641 Roosevelt Blvd
Philadelphia, PA 19124-2343
Phone (215) 831-4600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD029310EPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Pennsylvania Physician Alliance LLC CurrentSince Jun 1, 2020 Accepting new patients
Visiting Physicians of the Delaware Valley LLC Past Accepting new patients
Judy Anderson, MD, PC Past Accepting new patients

Locations

2 Hospital Dr
Clarion, PA 16214
Phone (800) 253-4906

722 E Butler Pike
Maple Glen, PA 19002
Phone (215) 643-7800

561 Fairthorne Ave
Philadelphia, PA 19128
Phone (215) 487-4000

4641 E Roosevelt Blvd
Philadelphia, PA 19124
Phone (215) 831-4600

Organizations & group practices 4

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1225072192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191544210",
            "telephone_number": "215-632-0693",
            "fax_number": "215-637-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191544210",
            "telephone_number": "215-632-0693",
            "fax_number": "215-637-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHNER",
        "first_name": "JOHN",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD023910E",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD023910E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007187560005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "LEICHNER",
            "middle_name": "P.",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.