NPIMap

Individual provider Active NPI

Mark A Leibel, MD

  • Critical Care Medicine (Anesthesiology) Physician
  • Madison, WI
National Provider Identifier
1689655995
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
44836 Issued in WI
Practice address
600 Highland Ave
B6/319 CSC
Madison, WI 53792-3272
Phone
(608) 263-8100
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44836 WI
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 44836 WI Primary

Addresses

Primary practice location

600 Highland Ave
B6/319 CSC
Madison, WI 53792-3272

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Other identifiers 6

IdentifierTypeStateIssuer
WI01N2OtherWIJOHN DEERE
390807236A3OtherWIUNITY
44836OtherWITOUCHPOINT
080190901OtherWIRAILROAD MEDICARE
13311OtherWIDEAN
34251400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160130000115 CO Practitioner - Anesthesiology 6800899329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Human Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder St
Suite 2508
Colorado Springs, CO 80909-5533
Phone (719) 365-6999

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Dec 11, 2017 Accepting new patients
Poudre Valley Medical Group, LLC Anesthesiology CurrentSince Dec 11, 2017 Accepting new patients
University of Wisconsin Medical Foundation Inc Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

1400 E Boulder St
Ste 1183
Colorado Springs, CO 80909
Phone (719) 365-6999

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045

1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1689655995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "address_2": "B6/319 CSC",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537923272",
            "telephone_number": "608-263-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBEL",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44836",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "WI",
            "license": "44836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "WI01N2",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITY",
            "identifier": "390807236A3",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOUCHPOINT",
            "identifier": "44836",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080190901",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN",
            "identifier": "13311",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34251400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.