Individual provider Active NPI

Sandra Leni, MD MS

  • Internal Medicine Physician
  • Severna Park, MD
National Provider Identifier
1760490270
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219947 Issued in NY
Practice address
645 Baltimore Annapolis Blvd Ste 213
Severna Park, MD 21146-3934
Phone
(240) 428-0528
NPI assigned
Aug 3, 2006
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219947 NY Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd Ste 213
Severna Park, MD 21146-3934

Mailing address

645 Baltimore Annapolis Blvd Ste 213
Severna Park, MD 21146-3934
Phone (240) 428-0528

Other identifiers 3

IdentifierTypeStateIssuer
02283425MedicaidNY
P010219947OtherBCBS
106585BJOtherPREFERRED CARE

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
I20110810000197 MD Practitioner - Internal Medicine 7911944434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
State University of New York at Buffalo School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

645 Baltimore Annapolis Blvd
Suite 213
Severna Park, MD 21146-3934
Phone (240) 428-0528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219947NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sandra Leni, MD, LLC Internal Medicine CurrentSince Jan 31, 2015 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians, Inc Internal Medicine CurrentSince Jul 2, 2015 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Jul 2, 2015 Accepting new patients

Locations

645 Baltimore Annapolis Blvd
Ste 213
Severna Park, MD 21146
Phone (240) 428-0528

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 4

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1760490270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD STE 213",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463934",
            "telephone_number": "240-428-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD STE 213",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463934",
            "telephone_number": "240-428-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENI",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "MD MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02283425",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P010219947",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "106585BJ",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.