Individual provider Active NPI

Nigel Lewis Leslie-Allen

  • Student in an Organized Health Care Education/Training Program
  • Livonia, MI
National Provider Identifier
1609570910
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
19000 St Joes Pkwy Ste 310
Livonia, MI 48152-1477
Phone
(734) 743-4540
Fax
(734) 743-4541
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 5101028461 MI
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

19000 St Joes Pkwy Ste 310
Livonia, MI 48152-1477

Mailing address

19000 St Joes Pkwy Ste 310
Livonia, MI 48152-1477
Phone (734) 743-4540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20260310000359 MI Practitioner - General PracticePractitioner - Psychiatry 5698135549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Psychiatry
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-3952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5101028461MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victor M. Cruz MD, P.C. Single Specialty CurrentSince Jan 6, 2026 Accepting new patients

Locations

17177 N Laurel Park Dr
Ste 131
Livonia, MI 48152
Phone (734) 462-3210

Organizations & group practices 1

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1609570910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19000 ST JOES PKWY STE 310",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521477",
            "telephone_number": "734-743-4540",
            "fax_number": "734-743-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19000 ST JOES PKWY STE 310",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521477",
            "telephone_number": "734-743-4540",
            "fax_number": "734-743-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE-ALLEN",
        "first_name": "NIGEL",
        "middle_name": "LEWIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101028461",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.