Leder Retina

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

LEDER RETINA

Doing business as

Leder Retina & Uveitis Specialist

Practice address

13241 Bartram Park Blvd Unit 809
Jacksonville, FL 32258-5216

Phone

(904) 201-9887

Fax

(904) 325-6434

NPI assigned

Jul 10, 2017

Organization subpart

No

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

Authorized official

Name

Henry Alexander Leder, MDNPI 1275563652

Title

Owner

Phone

(904) 201-9887

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Leder Retina & Uveitis Specialist Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Henry Alexander Leder, M.D.

  • Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
  • Jacksonville, FL
  • NPI 1275563652
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1609398916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 N LOMBARDY LOOP",
            "city": "FRUIT COVE",
            "state": "FL",
            "postal_code": "322595266",
            "telephone_number": "203-520-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 809",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585216",
            "telephone_number": "904-201-9887",
            "fax_number": "904-325-6434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 N Lombardy Loop",
            "address_purpose": "LOCATION",
            "city": "Fruit Cove",
            "state": "FL",
            "postal_code": "322595266",
            "country_code": "US",
            "telephone_number": "203-520-7393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEDER RETINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "LEDER",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-201-9887",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0108X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology, Uveitis and Ocular Inflammatory Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "D64669",
            "primary": false
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "MD",
            "license": "D64669",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048036300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leder Retina & Uveitis Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luz Medy Lebron Monclova, RN
• Karma Lechel
• Merry Noel Lechner
• Jillonne Lecompte, LMHC
• Dinah Lecount
• Henry Alexander Leder, M.D.
• Anisley Ledesma Espinosa, APRN, FNP-C
• Brittany Ryan Ledford, B.S.
• Heather Ledford, ARNP
• Eslene Ledgister

• Retina Specialist (Ophthalmology) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Retina Specialist (Ophthalmology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.