Organization Active NPI

Jeffrey S. Leider, MD,PC

  • Specialist
  • Farmington, MI
National Provider Identifier
1467527507
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301053044 Issued in MI
Legal business name
JEFFREY S. LEIDER, MD,PC
Practice address
24001 Orchard Lake Rd
Suite 170
Farmington, MI 48336-2555
Phone
(248) 615-4368
Fax
(248) 615-4342
NPI assigned
Nov 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeffrey S Ledier, MD
Title
President
Phone
(248) 615-4368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301053044 MI Primary

Addresses

Primary practice location

24001 Orchard Lake Rd
Suite 170
Farmington, MI 48336-2555

Mailing address

24001 Orchard Lake Rd
Suite 170
Farmington, MI 48336-2555
Phone (248) 615-4368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070116000378 MI Part B Supplier - Clinic/Group Practice 6406857523 Receives reassigned benefits from 1 practitioner
Practice locations: Brighton, MI; Farmington, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467527507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24001 ORCHARD LAKE RD",
            "address_2": "SUITE 170",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483362555",
            "telephone_number": "248-615-4368",
            "fax_number": "248-615-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24001 ORCHARD LAKE RD",
            "address_2": "SUITE 170",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483362555",
            "telephone_number": "248-615-4368",
            "fax_number": "248-615-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY S. LEIDER, MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEDIER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-615-4368",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301053044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.