Individual provider Active NPI

Mary L Leppert, MD

  • Pediatric Neurodevelopmental Disabilities Physician
  • Baltimore, MD
National Provider Identifier
1720136344
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
License
D41387 Issued in MD
Practice address
707 N Broadway
Baltimore, MD 21205-1832
Phone
(443) 923-9200
Fax
(443) 923-9405
NPI assigned
Jan 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X D41387 MD Primary

Addresses

Primary practice location

707 N Broadway
Baltimore, MD 21205-1832

Mailing address

2931 E Biddle St
Patient Accounting
Baltimore, MD 21213-3939
Phone (443) 923-1886

Other identifiers 2

IdentifierTypeStateIssuer
54337201OtherMDCAREFIRST BC BS
370011900MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000826 MD Practitioner - Pediatric MedicinePractitioner - Other (Physician) 9739168121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D41387MDMDPediatric Neurodevelopmental Disabilities Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Sep 1, 2000 Accepting new patients
Kennedy Krieger Associates CurrentSince Sep 1, 2000 Accepting new patients

Locations

2931 E Biddle St
Baltimore, MD 21213
Phone (443) 923-1872

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

707 N Broadway
#552
Baltimore, MD 21205

Interoperability endpoints

  • Direct secure messaging: mleppert124257@direct.hopkinsmedicine.org
  • Direct secure messaging: mleppert8840@direct.kennedykrieger.org

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720136344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 E BIDDLE ST",
            "address_2": "PATIENT ACCOUNTING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212133939",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-9200",
            "fax_number": "443-923-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPPERT",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "MD",
            "license": "D41387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC BS",
            "identifier": "54337201",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370011900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.