Leif George Nordstrom, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

45445 Issued in MA

Practice address

294 N Main St
Suite 101
East Longmeadow, MA 01028-1838

Phone

(413) 525-1870

Fax

(413) 525-3883

NPI assigned

Jan 4, 2006

Last updated

Mar 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/374254e6-8a71-4f61-90b5-064a630a4cd8/

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.

• Pediatric Services of Springfield, Inc.

  • Pediatric Adolescent Medicine Physician
  • East Longmeadow, MA
  • NPI 1790886091
  NPD (past)

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1538147129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 N MAIN ST",
            "address_2": "SUITE 101",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281838",
            "telephone_number": "413-525-1870",
            "fax_number": "413-525-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 N MAIN ST",
            "address_2": "SUITE 101",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281838",
            "telephone_number": "413-525-1870",
            "fax_number": "413-525-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDSTROM",
        "first_name": "LEIF",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "45445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9732314",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New England Orthopedic Surgeons
• Nancy N Ngaruiya
• Dan Thanh Linh Nguyen, DMD
• Trinh Nguyen, PHARMD
• Nilaab Noori
• Neil Nordstrom, DNP
• Northeast Orthopaedic Alliance PLLC
• William Paul Nowlan, LATC
• NSL East Village Place LLC
• Kayla O'Malley, D.P.M.

• Pediatric Adolescent Medicine Physician in East Longmeadow, MA
• Providers in East Longmeadow, MA by specialty
• Pediatric Adolescent Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; 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.