Individual provider Active NPI

Henry Alexander Leder, M.D.

  • Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
  • Jacksonville, FL
National Provider Identifier
1275563652
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Uveitis and Ocular Inflammatory Disease (Ophthalmology) PhysicianTaxonomy code 207WX0108X
License
ME131627 Issued in FL
Practice address
4100 Southpoint Dr E Ste 2
Jacksonville, FL 32216-8710
Phone
(904) 201-9887
Fax
(904) 325-6434
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D64669 MD
Ophthalmology Physician 207W00000X ME131627 FL
Retina Specialist (Ophthalmology) Physician 207WX0107X ME131627 FL
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician 207WX0108X ME131627 FL Primary

Addresses

Primary practice location

4100 Southpoint Dr E Ste 2
Jacksonville, FL 32216-8710

Mailing address

332 N Lombardy Loop
Saint Johns, FL 32259-5266
Phone (904) 201-9887

Other practice location 1

332 N Lombardy Loop
Saint Johns, FL 32259
Phone (904) 201-9887

Other identifiers 1

IdentifierTypeStateIssuer
009933300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170621002651 FL Practitioner - Ophthalmology 1355344268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Connecticut School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

332 N Lombardy Loop
Saint Johns, FL 32259-5266

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

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
ME131627FLMDOphthalmology Physician
D64669MDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1275563652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 N LOMBARDY LOOP",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322595266",
            "telephone_number": "904-201-9887",
            "fax_number": "904-325-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SOUTHPOINT DR E STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168710",
            "telephone_number": "904-201-9887",
            "fax_number": "904-325-6434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 N Lombardy Loop",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "FL",
            "postal_code": "32259",
            "country_code": "US",
            "telephone_number": "904-201-9887",
            "fax_number": "904-325-6434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDER",
        "first_name": "HENRY",
        "middle_name": "ALEXANDER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D64669",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME131627",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "FL",
            "license": "ME131627",
            "primary": false
        },
        {
            "code": "207WX0108X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Uveitis and Ocular Inflammatory Disease",
            "state": "FL",
            "license": "ME131627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.