Individual provider Active NPI

Michelle Leborys Hockstra, NP

  • Family Nurse Practitioner
  • Fulton, MD
National Provider Identifier
1528091329
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R121584 Issued in MD
Practice address
8197 Westside Blvd
Minute Clinic
Fulton, MD 20759-2590
Phone
(410) 627-6153
Fax
(301) 570-0990
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R121584 MD Primary

Addresses

Primary practice location

8197 Westside Blvd
Minute Clinic
Fulton, MD 20759-2590

Mailing address

2612 Triadelphia Lake Rd
Brookeville, MD 20833-1414
Phone (410) 627-6153

Other names 1

  • Michelle Leborys Former name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R121584MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC Past Accepting new patients
Yardmore Emergency Physicians LLC Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1528091329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 TRIADELPHIA LAKE RD",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208331414",
            "telephone_number": "410-627-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8197 WESTSIDE BLVD",
            "address_2": "MINUTE CLINIC",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592590",
            "telephone_number": "410-627-6153",
            "fax_number": "301-570-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCKSTRA",
        "first_name": "MICHELLE",
        "middle_name": "LEBORYS",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R121584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LEBORYS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.