Organization Active NPI

Scott Leydig, Psy.D., LLC

  • Psychologist
  • Plantation, FL
National Provider Identifier
1568949279
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY9401 Issued in FL
Legal business name
SCOTT LEYDIG, PSY.D., LLC
Practice address
130 S University Dr Ste D
Plantation, FL 33324-3347
Phone
(954) 579-2389
NPI assigned
Jul 25, 2018
Last updated
Jul 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Authorized official

Name
Scott Leydig, PSY.D.NPI 1770954604
Title
President
Phone
(954) 579-2389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY9401 FL Primary

Addresses

Primary practice location

130 S University Dr Ste D
Plantation, FL 33324-3347

Mailing address

130 S University Dr Ste D
Plantation, FL 33324-3347
Phone (954) 579-2389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180810001542 FL Part B Supplier - Clinic/Group Practice 4981952785 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

National Provider Directory

National Provider Directory

Locations

130 S University Dr
Ste D
Plantation, FL 33324
Phone (855) 453-9344

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1568949279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S UNIVERSITY DR STE D",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243347",
            "telephone_number": "954-579-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S UNIVERSITY DR STE D",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243347",
            "telephone_number": "954-579-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT LEYDIG, PSY.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "LEYDIG",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-579-2389",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY9401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.