Active NPI
Thomas L Leitner, M.D.
- Internal Medicine Physician
- Irving, TX
National Provider Identifier
1841377116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 51121-20
- Practice address
- 5001 Statesman Dr
Irving, TX 75063-2414 - Phone
- (469) 417-1127
- Fax
- (972) 983-0239
- NPI assigned
- Nov 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 10983 | NV | |
| Internal Medicine Physician | 207R00000X | 51121-20 | WI | Primary |
Addresses
Primary practice location
5001 Statesman Dr
Irving, TX 75063-2414
Mailing address
5001 Statesman Dr
Irving, TX 75063-2414
Phone (469) 417-1127
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35198000 | Medicaid | WI | |
| 100503884 | Medicaid | NV |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 51121-20 | WI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc, | Past | Accepting new patients |
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.
-
dba Dean Clinic-Beaver Dam Family & Sports Orthopedic Center
- Durable Medical Equipment & Medical Supplies
- Beaver Dam, WI
- NPI 1336425016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1841377116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5001 STATESMAN DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750632414",
"telephone_number": "469-417-1127",
"fax_number": "972-983-0239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5001 STATESMAN DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750632414",
"telephone_number": "469-417-1127",
"fax_number": "972-983-0239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEITNER",
"first_name": "THOMAS",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-01",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "10983",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "51121-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35198000",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100503884",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.