Organization Active NPI

Martin L. Leib MD PC

  • Ophthalmology Physician
  • New York, NY
National Provider Identifier
1255593380
Registry record updated Mar 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
124928 Issued in NY
Legal business name
MARTIN L. LEIB MD PC
Practice address
635 W 165TH St
Suite 230
New York, NY 10032-3724
Phone
(212) 305-2303
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2013

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

Authorized official

Name
Martin L. Leib, M.DNPI 1417970872
Title
Direct Owner
Phone
(212) 305-2303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 124928 NY Primary

Addresses

Primary practice location

635 W 165TH St
Suite 230
New York, NY 10032-3724

Mailing address

635 W 165TH St
Suite 230
New York, NY 10032-3724
Phone (212) 305-2303

Other identifiers 2

IdentifierTypeStateIssuer
00370356MedicaidNY
124928OtherNYLICENSE

National Provider Directory

National Provider Directory

Locations

635 W 165th St
Ste 230
New York, NY 10032
Phone (212) 305-2303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362441600000",
    "number": "1255593380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST",
            "address_2": "SUITE 230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "212-305-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W 165TH ST",
            "address_2": "SUITE 230",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323724",
            "telephone_number": "212-305-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN L. LEIB MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "LEIB",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "212-305-2303",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "124928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00370356",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "124928",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.