Individual provider Active NPI

Sarah Lynn Leo, DO

  • Allergy & Immunology Physician
  • Holland, MI
National Provider Identifier
1528564408
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
5101027751 Issued in MI
Practice address
3290 N Wellness Dr Ste 180
Holland, MI 49424-8047
Phone
(616) 738-4262
NPI assigned
Apr 1, 2018
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 5101027751 MI Primary
Pediatric Allergy/Immunology Physician 2080P0201X 5101027751 MI

Addresses

Primary practice location

3290 N Wellness Dr Ste 180
Holland, MI 49424-8047

Mailing address

12201 Hibner Rd
Hartland, MI 48353-1410
Phone (810) 516-9627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240829000261 MI Practitioner - Allergy/Immunology 0941619795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Allergy PCGroup PAC ID 9133136203, 2 clinicians

Practice addresses (Care Compare)

3290 N Wellness Dr
Suite 180
Holland, MI 49424-8047
Phone (616) 738-4262

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101027751MIMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Allergy PC CurrentSince Jul 15, 2024 Accepting new patients

Locations

3290 N Wellness Dr
Ste 180
Holland, MI 49424
Phone (616) 738-4262

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1528564408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 HIBNER RD",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483531410",
            "telephone_number": "810-516-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 N WELLNESS DR STE 180",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248047",
            "telephone_number": "616-738-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "SARAH",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "5101027751",
            "primary": true
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "MI",
            "license": "5101027751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.