Organization Active NPI

Leanne M Molia, M.D., P.C.

  • Ophthalmology Physician
  • Port Jefferson Station, NY
National Provider Identifier
1700189941
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
190247 Issued in NY
Legal business name
LEANNE M MOLIA, M.D., P.C.
Practice address
3 Medical Dr Ste B
Port Jefferson Station, NY 11776-1597
Phone
(631) 331-1966
NPI assigned
Dec 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Dr. Leanne Molia, MDNPI 1003908831
Title
President
Phone
(631) 331-1966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 190247 NY Primary

Addresses

Primary practice location

3 Medical Dr Ste B
Port Jefferson Station, NY 11776-1597

Mailing address

3 Medical Dr Ste B
Port Jefferson Station, NY 11776-1597
Phone (631) 331-1966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101216000002 NY Part B Supplier - Clinic/Group Practice 9830387950 Receives reassigned benefits from 1 practitioner
Practice locations: Port Jefferson Station, NY

National Provider Directory

National Provider Directory

Locations

3 Medical Dr
Ste B
Port Jefferson Station, NY 11776
Phone (631) 331-1966

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1700189941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MEDICAL DR STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761597",
            "telephone_number": "631-331-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL DR STE B",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761597",
            "telephone_number": "631-331-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEANNE M MOLIA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "MOLIA",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-331-1966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "190247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.