Individual provider Active NPI

Leah A. Danner, M.D.

  • Ophthalmology Physician
  • Ashland, WI
National Provider Identifier
1689627119
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
40013 Issued in WI
Practice address
1615 Maple Lane
Ashland, WI 54806
Phone
(715) 685-5500
Fax
(715) 682-4022
NPI assigned
May 18, 2006
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 40013 WI Primary

Addresses

Primary practice location

1615 Maple Lane
Ashland, WI 54806

Mailing address

1615 Maple Lane
Ashland, WI 54806
Phone (715) 685-5500

Other identifiers 1

IdentifierTypeStateIssuer
32458700MedicaidWI

Other names 1

  • Leah A. Eder Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060620000076 WI Practitioner - Ophthalmology 9436161189 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40013WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center Inc CurrentSince Jul 1, 2020 Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1689627119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LANE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "54806",
            "telephone_number": "715-685-5500",
            "fax_number": "715-682-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LANE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "54806",
            "telephone_number": "715-685-5500",
            "fax_number": "715-682-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNER",
        "first_name": "LEAH",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "40013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32458700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEAH",
            "last_name": "EDER",
            "middle_name": "A.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashland, WI

Sources for this page

Verify at the official NPI Registry.