Individual provider Active NPI

Peter C. Leising, LCSW-R

  • Clinical Social Worker
  • Amherst, NY
National Provider Identifier
1366485419
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R024846 Issued in NY
Practice address
4985 Harlem Road
Amherst, NY 14226
Phone
(716) 839-0500
Fax
(716) 839-0523
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R024846 NY Primary

Addresses

Primary practice location

4985 Harlem Road
Amherst, NY 14226

Mailing address

4985 Harlem Road
Amherst, NY 14226
Phone (716) 839-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070126000004 NY Practitioner - Clinical Social Worker 2264433754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Suburban Psychiatric Associates, LLPGroup PAC ID 6709774318, 35 clinicians

Practice addresses (Care Compare)

4535 Southwestern Blvd
Hamburg, NY 14075-1860
Phone (716) 689-3333

85 Bryant Woods S
Amherst, NY 14228-3604
Phone (716) 689-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R024846NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Psychiatric Associates, LLP CurrentSince Jan 21, 2013 Accepting new patients

Locations

85 Bryant Woods S
Buffalo, NY 14228
Phone (716) 689-3333

4535 Southwestern Blvd
Ste 704
Hamburg, NY 14075
Phone (716) 689-3333

Interoperability endpoints

  • Direct secure messaging: pleising@spa.medentdirect.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1366485419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4985 HARLEM ROAD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-0500",
            "fax_number": "716-839-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4985 HARLEM ROAD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "14226",
            "telephone_number": "716-839-0500",
            "fax_number": "716-839-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISING",
        "first_name": "PETER",
        "middle_name": "C.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R024846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.