Individual provider Active NPI

Michael C Leins, DO

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1326200957
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0054177 Issued in CO
Practice address
1025 Pennock PL Ste 114
Fort Collins, CO 80524-3257
Phone
(970) 495-8800
Fax
(970) 495-8820
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02003828A IN
Student in an Organized Health Care Education/Training Program 390200000X 11014445A IN
Family Medicine Physician 207Q00000X DR.0054177 CO Primary

Addresses

Primary practice location

1025 Pennock PL Ste 114
Fort Collins, CO 80524-3257

Mailing address

1025 Pennock PL Ste 114
Fort Collins, CO 80524-3257
Phone (970) 495-8800

Other practice location 1

10122 E 10th St Ste 100
Indianapolis, IN 46229-2697
Phone (317) 355-5717

Other identifiers 1

IdentifierTypeStateIssuer
P01146658OtherINRR MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 23, 2014 through Dec 23, 2026

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
11014445AINMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1326200957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL STE 114",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL STE 114",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243257",
            "telephone_number": "970-495-8800",
            "fax_number": "970-495-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10122 E 10th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462292697",
            "country_code": "US",
            "telephone_number": "317-355-5717",
            "fax_number": "317-355-3760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEINS",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003828A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11014445A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0054177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P01146658",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.