Individual provider Active NPI

Adrianna L. Leppek, O.D.

  • Optometrist
  • Shelby TWP, MI
National Provider Identifier
1679793848
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003765 Issued in MI
Practice address
45460 Market St
Shelby TWP, MI 48315-6224
Phone
(586) 580-2001
NPI assigned
Apr 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003765 MI Primary

Addresses

Primary practice location

45460 Market St
Shelby TWP, MI 48315-6224

Mailing address

5127 Montgomery Dr
Shelby Township, MI 48316-4121
Phone (586) 997-1249

Other practice location 1

30550 Stephenson Hwy
Madison Heights, MI 48071-1611
Phone (248) 616-0087

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116000470 MI Practitioner - Optometry 7315399318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1679793848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5127 MONTGOMERY DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164121",
            "telephone_number": "586-997-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45460 MARKET ST",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483156224",
            "telephone_number": "586-580-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30550 Stephenson Hwy",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "MI",
            "postal_code": "480711611",
            "country_code": "US",
            "telephone_number": "248-616-0087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEPPEK",
        "first_name": "ADRIANNA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

Verify at the official NPI Registry.