Individual provider Active NPI

Carl M Leichter, M.D.

  • Dermatology Physician
  • Scottsdale, AZ
National Provider Identifier
1801893607
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
308999 Issued in AZ
Practice address
38375 N 102ND St
Scottsdale, AZ 85262-3012
Phone
(516) 967-1132
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 126210-1 NY
Dermatology Physician 207N00000X 308999 AZ Primary

Addresses

Primary practice location

38375 N 102ND St
Scottsdale, AZ 85262-3012

Mailing address

38375 N 102ND St
Scottsdale, AZ 85262-3012
Phone (516) 967-1132

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 Medicine

State licenses

LicenseStateTypeSpecialty
308999AZMDDermatology Physician
126210-1NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Nassau Dermatology P.C. Dermatology CurrentSince Jan 1, 1999 Accepting new patients

Locations

2900 Hempstead Tpke
Levittown, NY 11756
Phone (516) 520-5500

303 E Park Ave
Long Beach, NY 11561
Phone (516) 431-2020

258 Merrick Rd
Oceanside, NY 11572
Phone (516) 766-0345

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1801893607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38375 N 102ND ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852623012",
            "telephone_number": "516-967-1132",
            "fax_number": "516-766-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38375 N 102ND ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852623012",
            "telephone_number": "516-967-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHTER",
        "first_name": "CARL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "126210-1",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "308999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.