Individual provider Active NPI

Andrea Nikole Leezer, LCSW

  • Clinical Social Worker
  • Quincy, IL
National Provider Identifier
1710593124
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149022303 Issued in IL
Practice address
927 Broadway St Ste 331
Quincy, IL 62301-2721
Phone
(217) 224-4453
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149022303 IL Primary

Addresses

Primary practice location

927 Broadway St Ste 331
Quincy, IL 62301-2721

Mailing address

927 Broadway St Ste 331
Quincy, IL 62301-2721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201202002633 IL Practitioner - Clinical Social Worker 2668883299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

927 Broadway St
Quincy, IL 62301-2719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince Feb 1, 2021 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Blessing Hospital CurrentSince Feb 1, 2021 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Blessing Hospital PastSince Sep 27, 2020 Accepting new patients
Blessing Corporate Services Inc PastSince Sep 27, 2020 Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

927 Broadway St
Ste 331
Quincy, IL 62301
Phone 2172244453 ext. 4553

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod

Organizations & group practices 6

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1710593124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 BROADWAY ST STE 331",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 BROADWAY ST STE 331",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012721",
            "telephone_number": "217-224-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEZER",
        "first_name": "ANDREA",
        "middle_name": "NIKOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.