Active NPI
Marie Christine Leisz, DO
- Physical Medicine & Rehabilitation Physician
- St. Paul, MN
National Provider Identifier
1740214014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 40993
- Practice address
- 280 North Smith Avenue
Doctors Professional Building
St. Paul, MN 55102-2459 - Phone
- (651) 241-8295
- NPI assigned
- Jul 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 40993 | MN | Primary |
Addresses
Primary practice location
280 North Smith Avenue
Doctors Professional Building
St. Paul, MN 55102-2459
Mailing address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 241-8295
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BLUECROSS BLUESHIELD | Other | MN | BLUECROSS BLUE SHIELD |
| 2311446 | Other | MEDICA - CHOICE | |
| HP28829 | Other | HEALTHPARTNERS | |
| 0511188 | Medicaid | IA | |
| 1017577 | Other | PREFERREDONE | |
| 122837 | Other | UCARE | |
| 23-00008 | Other | MEDICA - PRIMARY | |
| 32446800 | Medicaid | WI | |
| 071729100 | Medicaid | MN | |
| ARAZ | Other | 835296 |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mleisz58642@excellian.direct.allina.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40993 | MN | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Dizzy & Balance Center,LTD. | Physical Medicine & Rehabilitation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Medicine & Rehabilitation Physician
- Bloomington, MN
- NPI 1023021938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1740214014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 CHICAGO AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554071321",
"telephone_number": "651-241-8295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 NORTH SMITH AVENUE",
"address_2": "DOCTORS PROFESSIONAL BUILDING",
"city": "ST. PAUL",
"state": "MN",
"postal_code": "551022459",
"telephone_number": "651-241-8295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEISZ",
"first_name": "MARIE",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MN",
"license": "40993",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD",
"identifier": "BLUECROSS BLUESHIELD",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA - CHOICE",
"identifier": "2311446",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP28829",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0511188",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "1017577",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "122837",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA - PRIMARY",
"identifier": "23-00008",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32446800",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "071729100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "835296",
"identifier": "ARAZ",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mleisz58642@excellian.direct.allina.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "280 North Smith Avenue",
"address_2": "Doctors Professional Building",
"city": "St. Paul",
"state": "MN",
"country_code": "US",
"postal_code": "551022459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in St. Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.