Braeden Leiby, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1671160 Issued in ID

Practice address

465 Memorial Dr
Pocatello, ID 83201-4008

Phone

(208) 232-7862

NPI assigned

May 31, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: braeden.leiby.1@13153.direct.athenahealth.com
• Direct secure messaging: braeden.leiby.1@16258.direct.athenahealth.com
• Direct secure messaging: bleiby1005013@ahs.direct-ci.com

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1780424184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 400",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014880",
            "telephone_number": "208-232-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-232-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBY",
        "first_name": "BRAEDEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-31",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "1671160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Kay Lee, M.S. CCC-SLP
• Yaeeun Lee, M.S.
• Luc Day Leech, OTR/L
• Legacy Healthcare Group
• Lacy Lehman, LCSW
• Kimberly Leishman, LPC,
• Benjamin Doran Lemmon
• Alexander Lemon
• Richard W Lemon, M.P.T.
• Marcial Rodrigo Lemos

• Family Medicine Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.