Individual provider Active NPI

Stephen P Leff, MD

  • Ophthalmology Physician
  • Decatur, GA
National Provider Identifier
1366434698
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
017845 Issued in GA
Practice address
465 Winn Way
Ste 140
Decatur, GA 30030-1753
Phone
(404) 298-5557
Fax
(404) 297-9480
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 017845 GA Primary

Addresses

Primary practice location

465 Winn Way
Ste 140
Decatur, GA 30030-1753

Mailing address

5259 Meadowcreek Dr
Dunwoody, GA 30338-3849
Phone (770) 393-0851

Other identifiers 3

IdentifierTypeStateIssuer
0816463OtherGAUNITED HEALTH CARE INS
0522968OtherGAAETNA INS
572149OtherGABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017845GAMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1366434698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5259 MEADOWCREEK DR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303383849",
            "telephone_number": "770-393-0851",
            "fax_number": "404-297-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 WINN WAY",
            "address_2": "STE 140",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301753",
            "telephone_number": "404-298-5557",
            "fax_number": "404-297-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFF",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "017845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE INS",
            "identifier": "0816463",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INS",
            "identifier": "0522968",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "572149",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.