Individual provider Active NPI

Owen R Leiba, REGISTERED NURSE

  • Registered Nurse
  • New York, NY
National Provider Identifier
1578043725
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
745676 Issued in NY
Practice address
279 E 3Rd St
New York, NY 10009-7813
Phone
(212) 477-8884
Fax
(212) 866-0559
NPI assigned
Aug 17, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 745676 NY Primary

Addresses

Primary practice location

279 E 3Rd St
New York, NY 10009-7813

Mailing address

279 E 3Rd St
New York, NY 10009-7813
Phone (212) 477-8884

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
745676NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1578043725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097813",
            "telephone_number": "212-477-8884",
            "fax_number": "212-866-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097813",
            "telephone_number": "212-477-8884",
            "fax_number": "212-866-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBA",
        "first_name": "OWEN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "745676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.