NPIMap

Individual provider Active NPI

Michael J Leddy III, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Alexandria, LA
National Provider Identifier
1821052028
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
MD024005 Issued in LA
Practice address
3351 Masonic Dr
Alexandria, LA 71301-3842
Phone
(318) 473-9556
Fax
(318) 441-8339
NPI assigned
Apr 14, 2006
Last updated
Apr 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME0088196 FL
Orthopaedic Surgery Physician 207X00000X MD.024005 LA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD024005 LA Primary

Addresses

Primary practice location

3351 Masonic Dr
Alexandria, LA 71301-3842

Mailing address

3444 Masonic Dr
Alexandria, LA 71301-3615
Phone (318) 473-9556

Other identifiers 2

IdentifierTypeStateIssuer
1484831MedicaidLA
4K904F735OtherLALA MEDICARE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080111000695 LA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 0648351940 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Boston University School of Medicine, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians
Mid State Orthopaedic and Sports Medicine Center LLCGroup PAC ID 6204892540, 27 clinicians

Practice addresses (Care Compare)

301 W Fertitta Blvd
Suite 4
Leesville, LA 71446-4665
Phone (337) 238-9931

3444 Masonic Dr
Alexandria, LA 71301-3615
Phone 31844183291329

429 Rocky Bayou Dr
Suite a
Pineville, LA 71360-8133
Phone 31847395561329

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)28
Upper limb (arm) arthroscopy (minimally invasive joint repair)53
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0088196FLMDOrthopaedic Surgery Physician
MD.024005LAMDOrthopaedic Surgery Physician
MD024005LAMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsuhn Billing LLC CurrentSince Jun 11, 2014 Accepting new patients
University Hospital & Clinics, Inc. CurrentSince Dec 1, 2014 Accepting new patients
University Hospital & Clinics Inc CurrentSince Dec 1, 2014 Accepting new patients
Lsuhn Billing LLC CurrentSince Jun 11, 2014 Accepting new patients
Karr and Kornberg Orthopaedic Associates, MD, PA Orthopaedic Surgery Past Accepting new patients
Huey P. Long Medical Center Past Accepting new patients
Physical and Occupational Therapy of Alexandria, LLC PastSince Feb 2, 2023 Accepting new patients

Locations

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

Organizations & group practices 9

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1821052028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013615",
            "telephone_number": "318-473-9556",
            "fax_number": "318-441-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013842",
            "telephone_number": "318-473-9556",
            "fax_number": "318-441-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDDY",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0088196",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "LA",
            "license": "MD.024005",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "LA",
            "license": "MD024005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1484831",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA MEDICARE NUMBER",
            "identifier": "4K904F735",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.