Individual provider Active NPI

John D Leimert, M.D.

  • Pediatrics Physician
  • Wareham, MA
National Provider Identifier
1568407393
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
55255 Issued in MA
Practice address
100 Rosebrook Way
Wareham, MA 02571-1138
Phone
(508) 973-4942
Fax
(508) 973-0306
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 55255 MA Primary

Addresses

Primary practice location

100 Rosebrook Way
Wareham, MA 02571-1138

Mailing address

200 Mill Rd
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210716001262 MA Practitioner - Pediatric Medicine 3577965284 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Pediatric Associates of Fall River, Inc Pediatrics Past Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

49 State Rd
Ste 202
North Dartmouth, MA 02747
Phone (508) 973-9240

49 State Rd
North Dartmouth, MA 02747
Phone (508) 973-9240

100 Rosebrook Way
Wareham, MA 02571
Phone (508) 273-4900

Interoperability endpoints

  • Direct secure messaging: jleimert20085@direct.southcoast.org

Organizations & group practices 3

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1568407393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROSEBROOK WAY",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025711138",
            "telephone_number": "508-973-4942",
            "fax_number": "508-973-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIMERT",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "55255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wareham, MA

Sources for this page

Verify at the official NPI Registry.