Active NPI
Ilya M Leyngold, MD
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Meridian, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Plastic and Reconstructive Surgery Physician
- License
- M-15568
- Practice address
- 3015 E Goldstone Dr # 130
Meridian, ID 83642-1549 - Phone
- (208) 900-4673
- Fax
- (208) 266-5033
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Plastic and Reconstructive Surgery Physician | 207WX0200X | M-15568 | ID | Primary |
Addresses
Primary practice location
3015 E Goldstone Dr # 130
Meridian, ID 83642-1549
Mailing address
3015 E Goldstone Dr Ste 130
Meridian, ID 83642-1224
Phone (208) 900-4673
Other practice location 1
3475 Erwin Rd
Durham, NC 27705-0005
Phone (919) 684-4224
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14L01 | Other | FL | BLUE CROSS BLUE SHIELD |
| 005984000 | Medicaid | FL | |
| 20024216 | Other | ID | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Johns Hopkins University School of Medicine, 2006
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
3015 E Goldstone Dr
Suite 130
Meridian, ID 83642-1549
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-15568 | ID | MD | Ophthalmic Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leyngold Institute for Plastic Surgery PLLC | Current | Accepting new patients | |
| Oculoplastic Surgery, Inc. | Ophthalmology | Past | Accepting new patients |
| Duke Health Integrated Practice, Inc. | Past | Accepting new patients |
Locations
3015 E Goldstone Dr
Ste 130
Meridian, ID 83642
Phone (208) 900-4673
Interoperability endpoints
- ileyngold263172@direct.medicine.duke.edu
- ileyngold1684528@direct.trinity-health.org
Organizations & group practices 3
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.
-
dba Leyngold Institute for Plastic Surgery
- Plastic and Reconstructive Surgery Physician
- Meridian, ID
- NPI 1972277895
-
- General Practice Physician
- Durham, NC
- NPI 1205553369
-
dba Still Canyon Eyelid & Facial Plastic Surgery
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Holladay, UT
- NPI 1578780805
Ophthalmology
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1407996176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3015 E GOLDSTONE DR STE 130",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421224",
"telephone_number": "208-900-4673",
"fax_number": "208-266-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3015 E GOLDSTONE DR # 130",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421549",
"telephone_number": "208-900-4673",
"fax_number": "208-266-5033"
}
],
"practiceLocations": [
{
"address_1": "3475 Erwin Rd",
"address_purpose": "LOCATION",
"city": "Durham",
"state": "NC",
"postal_code": "277050005",
"country_code": "US",
"telephone_number": "919-684-4224",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEYNGOLD",
"first_name": "ILYA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207WX0200X",
"taxonomy_group": "",
"desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
"state": "ID",
"license": "M-15568",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "14L01",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005984000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "20024216",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.