Individual provider Active NPI

Leslie Leicht, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Memphis, TN
National Provider Identifier
1467530618
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
48942 Issued in TN
Practice address
1282 Union Ave
Memphis, TN 38104-3414
Phone
(989) 657-1370
Fax
(818) 671-2225
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X LL069193 MI
Specialist 174400000X 48942 TN
Physical Medicine & Rehabilitation Physician 208100000X 48942 TN Primary

Addresses

Primary practice location

1282 Union Ave
Memphis, TN 38104-3414

Mailing address

8483 Silverwind Dr
Memphis, TN 38125-1730
Phone (989) 657-1370

Other identifiers 5

IdentifierTypeStateIssuer
LL069193OtherMISTATE LIS #
1529398MedicaidTN
4337224OtherTNBCBS OF TN
5921502MedicaidNC
4657739MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121113000560 TN Practitioner - Physical Medicine and Rehabilitation 0749268472 Practice locations: Memphis, TN
I20150731015422 VA Practitioner - Physical Medicine and RehabilitationPractitioner - Internal Medicine 0749268472 Practice locations: Bristol, VA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL069193MIMDSpecialist
48942TNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of the Midwest, S.C. Physical Medicine & Rehabilitation Past Accepting new patients
Rehabilitation Medicine Clinic, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lleicht29590@mlh.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1467530618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8483 SILVERWIND DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381251730",
            "telephone_number": "989-657-1370",
            "fax_number": "901-821-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043414",
            "telephone_number": "989-657-1370",
            "fax_number": "818-671-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHT",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "LL069193",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "48942",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "48942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIS #",
            "identifier": "LL069193",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529398",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4337224",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921502",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4657739",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.