Leonard M Haltrecht, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS002378L Issued in PA

Practice address

1999 Sproul Rd
Ste 21
Broomall, PA 19008-3508

Phone

(610) 353-5840

Fax

(610) 353-3420

NPI assigned

May 24, 2005

Reactivated

Jul 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Leonard Haltrecht

  • Family Medicine Physician
  • Broomall, PA
  • NPI 1558386342
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1265435069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 SPROUL RD",
            "address_2": "STE 21",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083508",
            "telephone_number": "610-353-5840",
            "fax_number": "610-353-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 SPROUL RD",
            "address_2": "STE 21",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083508",
            "telephone_number": "610-353-5840",
            "fax_number": "610-353-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALTRECHT",
        "first_name": "LEONARD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-04-08",
        "deactivation_date": "2006-03-31",
        "reactivation_date": "2006-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS002378L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007336180001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0032051001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6548",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "041839",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marian G Hall, OT
• Courtney B Hammerel, MD
• Edward Haughey, PT
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• Family Medicine Physician in Broomall, PA
• Providers in Broomall, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.