NPIMap

Individual provider Active NPI

Timothy Michael Leicht, PA-C

  • Physician Assistant
  • Clinton TWP, MI
National Provider Identifier
1831472067
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007605 Issued in MI
Practice address
15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Phone
(800) 653-6568
Fax
(313) 876-1305
NPI assigned
Sep 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055110 PA
Surgical Physician Assistant 363AS0400X MA055110 PA
Physician Assistant 363A00000X 5601007605 MI Primary
Medical Physician Assistant 363AM0700X MA055110 PA

Addresses

Primary practice location

15855 19 Mile Rd
Clinton TWP, MI 48038-3504

Mailing address

15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Phone (800) 653-6568

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-4021

Other practice location 2

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-8432

Other practice location 3

44555 Woodward Ave Ste 506
Pontiac, MI 48341-5039
Phone (248) 858-3850

Other practice location 4

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tleicht6583271@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200318000463 MI Practitioner - Physician Assistant 4284801010 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians
Iha Olma Specialty Services LLCGroup PAC ID 8426464884, 42 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089

28100 Grand River Ave
Farmington Hills, MI 48336-5970

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-2270

5315 Elliott Dr
201 Trinity Health Iha Medical Group Hepato
Ypsilanti, MI 48197-8634
Phone (248) 287-7820

Hospital & facility affiliations

  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601007605MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Olma Specialty Services LLC CurrentSince Jan 1, 2026 Accepting new patients
McLaren Greater Lansing Physician Assistant CurrentSince Jan 28, 2020 Accepting new patients
Iha Olma Specialty Services LLC CurrentSince Jan 1, 2026 Accepting new patients
Henry Ford Macomb Hospital Corporation Medical CurrentSince Mar 30, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Mar 30, 2022 Accepting new patients
Mid-Michigan Physicians, PC Physician Assistant Past Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
McLaren Greater Lansing Past Accepting new patients
Physician Assistant Surgical Associates, LLC Surgical Past Accepting new patients

Locations

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

3520 Forest Rd
Ste 200
Lansing, MI 48910

3520 Forest Rd
Lansing, MI 48910
Phone (517) 975-7800

405 W Greenlawn Ave
Ste 305
Lansing, MI 48910
Phone (517) 483-4780

44555 Woodward Ave
Ste 506
Pontiac, MI 48341
Phone (248) 334-2568

1854 W Auburn Rd
Ste 100B
Rochester Hills, MI 48309
Phone (248) 218-9260

Interoperability endpoints

  • Direct secure messaging: tleicht785295@direct.hfhs.org

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1831472067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "800-653-6568",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "800-653-6568",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-4021",
            "fax_number": "248-898-1473",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-8432",
            "fax_number": "248-964-8420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44555 Woodward Ave Ste 506",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483415039",
            "country_code": "US",
            "telephone_number": "248-858-3850",
            "fax_number": "248-858-3833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-593-7000",
            "fax_number": "313-593-8840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEICHT",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055110",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA055110",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007605",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tleicht6583271@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.