NPIMap

Individual provider Active NPI

Douglas R Leder, D.O.

  • Ophthalmology Physician
  • West Palm Beach, FL
National Provider Identifier
1396718565
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
OS4720 Issued in FL
Practice address
500 Northpoint Pkwy
#100
West Palm Beach, FL 33407-1903
Phone
(561) 686-2020
Fax
(561) 686-6204
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X OS4720 FL Primary
Ophthalmology Physician 207W00000X 91293 SC

Addresses

Primary practice location

500 Northpoint Pkwy
#100
West Palm Beach, FL 33407-1903

Mailing address

500 Northpoint Pkwy
#100
West Palm Beach, FL 33407-1903
Phone (561) 686-2020

Other practice location 1

104 Simpson St
Greenville, SC 29605-4413
Phone (864) 522-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100804001283 FL Practitioner - Ophthalmology 6305979725
I20240314003836 SC Practitioner - Ophthalmology 6305979725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Rowan University School of Osteopathic Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

104 Simpson St
Greenville, SC 29605-4413
Phone (864) 236-9888

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS4720FLMDOphthalmology Physician
91293SCMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Apr 8, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Apr 8, 2024 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

104 Simpson St
Greenville, SC 29605
Phone (864) 236-9888

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

Interoperability endpoints

  • Direct secure messaging: dleder@stlucieeye.intellechartdirect.net
  • Direct secure messaging: dleder758600@direct.ghs.myhfn.org

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1396718565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NORTHPOINT PKWY",
            "address_2": "#100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334071903",
            "telephone_number": "561-686-2020",
            "fax_number": "561-686-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 NORTHPOINT PKWY",
            "address_2": "#100",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334071903",
            "telephone_number": "561-686-2020",
            "fax_number": "561-686-6204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Simpson St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054413",
            "country_code": "US",
            "telephone_number": "864-522-3900",
            "fax_number": "864-522-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDER",
        "first_name": "DOUGLAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "OS4720",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "91293",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.