Individual provider Active NPI

Joseph Matthew Leppek, O.D.

  • Optometrist
  • Fenton, MI
National Provider Identifier
1225442759
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004827 Issued in MI
Practice address
1425 N. Leroy St.
Fenton, MI 48430
Phone
(810) 629-2041
Fax
(810) 629-9366
NPI assigned
Jun 12, 2014
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004827 MI Primary

Addresses

Primary practice location

1425 N. Leroy St.
Fenton, MI 48430

Mailing address

1425 N Leroy St
Fenton, MI 48430-2763
Phone (810) 629-2041

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113001136 MI Practitioner - Optometry 1456573153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Nova Southeastern Univ College of Dental Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joseph M Leppek OD PLLCGroup PAC ID 0547482242, 2 clinicians

Practice addresses (Care Compare)

1425 N Leroy St
Diamond Optical Care
Fenton, MI 48430-2763
Phone (810) 629-2041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph M Leppek O.D. PLLC Optometrist CurrentSince Sep 15, 2014 Accepting new patients

Locations

1425 N Leroy St
Fenton, MI 48430
Phone (810) 629-2041

12770 S Saginaw St
Grand Blanc, MI 48439
Phone (810) 695-3500

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, 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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1225442759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 N LEROY ST",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302763",
            "telephone_number": "810-629-2041",
            "fax_number": "810-629-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N. LEROY ST.",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-629-2041",
            "fax_number": "810-629-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPPEK",
        "first_name": "JOSEPH",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.