Individual provider Active NPI

Mayumi L. Cayde Leslie, M.D.

  • Family Medicine Physician
  • Michigan City, IN
National Provider Identifier
1457485013
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01074116A Issued in IN
Practice address
4111 Franklin St
Michigan City, IN 46360-7803
Phone
(219) 873-2919
Fax
(219) 873-2909
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53311 WI
Family Medicine Physician 207Q00000X 01074116A IN Primary

Addresses

Primary practice location

4111 Franklin St
Michigan City, IN 46360-7803

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

916 E Main St
Winneconne, WI 54986-9782
Phone (920) 582-1100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150206001169 IN Practitioner - Family Practice 0941353635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

4111 Franklin St
Michigan City, IN 46360-7803
Phone (219) 873-2919

Hospital & facility affiliations

  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Jun 1, 2024 Accepting new patients
Franciscan Physician Network CurrentSince Jun 1, 2024 Accepting new patients
Franciscan Physician Network Family Medicine Current Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc PastSince Mar 19, 2023 Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

4111 Franklin St
Michigan City, IN 46360
Phone (219) 873-2919

7905 Calumet Ave
Munster, IN 46321
Phone (219) 836-5800

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1457485013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 FRANKLIN ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607803",
            "telephone_number": "219-873-2919",
            "fax_number": "219-873-2909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 E Main St",
            "address_purpose": "LOCATION",
            "city": "Winneconne",
            "state": "WI",
            "postal_code": "549869782",
            "country_code": "US",
            "telephone_number": "920-582-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAYDE LESLIE",
        "first_name": "MAYUMI",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "53311",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01074116A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

Verify at the official NPI Registry.