NPIMap

Individual provider Active NPI

Henry Theodore Leis, M.D.

  • Orthopaedic Surgery Physician
  • Biloxi, MS
National Provider Identifier
1417946013
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
19613 Issued in MS
Practice address
1720A Medical Park Dr
Suite 220
Biloxi, MS 39532-2129
Phone
(228) 392-9355
Fax
(228) 392-1781
NPI assigned
Oct 17, 2005
Last updated
Mar 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 19613 MS Primary
Orthopaedic Hand Surgery Physician 207XS0106X 19613 MS

Addresses

Primary practice location

1720A Medical Park Dr
Suite 220
Biloxi, MS 39532-2129

Mailing address

6300 E Lake Blvd
Ste. 301
Vancleave, MS 39565-6770
Phone (228) 230-2663

Other identifiers 2

IdentifierTypeStateIssuer
512I200015OtherMSMEDICARE PTAN
06608789MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080204000675 MS Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 6507948130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1720 A Medical Park Dr
Suite 220
Biloxi, MS 39532-2127
Phone (228) 392-9355

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)53
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19613MSMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bienville Orthopaedic Specialists, LLC Orthopaedic Surgery CurrentSince Oct 1, 2007 Accepting new patients
Bienville Orthopaedic Specialists, LLC Orthopaedic Surgery CurrentSince Oct 1, 2007 Accepting new patients
Oal Care of Al, LLC Orthopaedic Surgery CurrentSince Jan 23, 2021 Accepting new patients

Locations

1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355

6300 E Lake Blvd
Ste 201
Vancleave, MS 39565
Phone (228) 206-2263

6300 E Lake Blvd
Ste 301
Vancleave, MS 39565

102 Woodmont Blvd
Ste 350
Nashville, TN 37205
Phone (615) 297-1020

Interoperability endpoints

  • Direct secure messaging: henry.leis@bienvilleortho.emadirect.md
  • Direct secure messaging: hleis@direct.mhg.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1417946013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE BLVD",
            "address_2": "STE. 301",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395656770",
            "telephone_number": "228-230-2663",
            "fax_number": "228-206-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720A MEDICAL PARK DR",
            "address_2": "SUITE 220",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322129",
            "telephone_number": "228-392-9355",
            "fax_number": "228-392-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIS",
        "first_name": "HENRY",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MS",
            "license": "19613",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "MS",
            "license": "19613",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "512I200015",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06608789",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.