Active NPI
Leyla Moossavi, M.D.
- Obstetrics & Gynecology Physician
- Mount Pleasant, MI
National Provider Identifier
1457387151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 4301065333
- Practice address
- 1621 E Broomfield St
Suite a
Mount Pleasant, MI 48858-5427 - Phone
- (989) 775-7492
- Fax
- (989) 775-6892
- NPI assigned
- Jun 24, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 4301065333 | MI | Primary |
Addresses
Primary practice location
1621 E Broomfield St
Suite a
Mount Pleasant, MI 48858-5427
Mailing address
1621 E Broomfield St
Suite a
Mt Pleasant, MI 48858-5427
Phone (989) 775-7492
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1603700871 | Other | MI | BCBSM |
| 200000005818 | Other | MI | PHP COMMERCIAL |
| 4711889 | Medicaid | MI | |
| 1006844 | Other | MI | MCLAREN HEALTH PLAN |
| 0986427 | Other | MI | HEALTHPLUS COMMERCIAL |
| 1006843 | Other | MI | MCLAREN HEALTH PLAN |
| 4349365 | Medicaid | MI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4301065333 | MI | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1457387151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 E BROOMFIELD ST",
"address_2": "SUITE A",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488585427",
"telephone_number": "989-775-7492",
"fax_number": "989-775-6892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 E BROOMFIELD ST",
"address_2": "SUITE A",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488585427",
"telephone_number": "989-775-7492",
"fax_number": "989-775-6892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOSSAVI",
"first_name": "LEYLA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-24",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MI",
"license": "4301065333",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "1603700871",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP COMMERCIAL",
"identifier": "200000005818",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4711889",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH PLAN",
"identifier": "1006844",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPLUS COMMERCIAL",
"identifier": "0986427",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCLAREN HEALTH PLAN",
"identifier": "1006843",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4349365",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.