Individual provider Active NPI

Bryan Eric Leader, D.C.

  • Chiropractor
  • Auburn, NY
National Provider Identifier
1669772034
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X001207-1 Issued in NY
Practice address
2115 W Genesee Street Rd
Auburn, NY 13021-9435
Phone
(315) 252-5789
NPI assigned
Nov 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X001207-1 NY Primary

Addresses

Primary practice location

2115 W Genesee Street Rd
Auburn, NY 13021-9435

Mailing address

40 Elm St
Auburn, NY 13021-2119
Phone (315) 730-8948

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110829000070 NY Practitioner - Chiropractic 7517137698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X001207-1NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Bryan E Leader Chiropractic LLC Chiropractor CurrentSince May 15, 2014 Accepting new patients
Finger Lakes Chiropractic & Massage Therapy, PLLC Chiropractor PastSince Jul 29, 2014 Accepting new patients
Leader Chiropractic Chiropractor PastSince May 18, 2014 Accepting new patients

Locations

2115 W Genesee Street Rd
Auburn, NY 13021
Phone (315) 252-5789

2115 W Genesee Street Rd
Ste 1
Auburn, NY 13021

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1669772034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ELM ST",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130212119",
            "telephone_number": "315-730-8948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W GENESEE STREET RD",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "130219435",
            "telephone_number": "315-252-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "BRYAN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X001207-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.