NPIMap

Individual provider Active NPI

Douglas Clarence Leder, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Leesport, PA
National Provider Identifier
1851824726
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS021306 Issued in PA
Practice address
5 S Centre Ave Ste A3
Leesport, PA 19533-8661
Phone
(610) 921-6570
Fax
(610) 926-8352
NPI assigned
Apr 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X OS021306 PA Primary

Addresses

Primary practice location

5 S Centre Ave Ste A3
Leesport, PA 19533-8661

Mailing address

5 S Centre Ave Ste A3
Leesport, PA 19533-8661
Phone (610) 921-6570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210707000066 PA Practitioner - Family PracticePractitioner - Sports Medicine 9830433077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Joseph Medical GroupGroup PAC ID 3779688650, 190 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

145 N 6TH St FL
2 SJMG Family and Women's Care
Reading, PA 19601-3096
Phone (610) 208-4554

2000 Westinghouse Dr
Cranberry Township, PA 16066-5238

5 S Centre Ave
Suite A3 Pshmg Schuylkill Valley
Leesport, PA 19533-8661
Phone (610) 926-5707

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.31 of 100Reported as group
Quality
55.01
Promoting interoperability
99
Improvement activities
40
Cost
76.86

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
65.84
Promoting interoperability
100
Improvement activities
40
Cost
77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
St. Joseph Medical Group Family Medicine CurrentSince Jul 15, 2021 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Oct 1, 2022 Accepting new patients
St. Joseph Medical Group CurrentSince Jul 15, 2021 Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

5 S Centre Ave
Ste A3
Leesport, PA 19533
Phone (610) 921-6570

3970 Perkiomen Ave
Ste 102
Reading, PA 19606
Phone (610) 779-1330

2494 Bernville Rd
Ste 200
Reading, PA 19605
Phone (610) 378-2557

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

145 N 6th St
Fl 2
Reading, PA 19601
Phone (610) 208-4558

Organizations & group practices 5

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 7

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1851824726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 S CENTRE AVE STE A3",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338661",
            "telephone_number": "610-921-6570",
            "fax_number": "610-926-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S CENTRE AVE STE A3",
            "city": "LEESPORT",
            "state": "PA",
            "postal_code": "195338661",
            "telephone_number": "610-921-6570",
            "fax_number": "610-926-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDER",
        "first_name": "DOUGLAS",
        "middle_name": "CLARENCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-07",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "PA",
            "license": "OS021306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesport, PA

Sources for this page

Verify at the official NPI Registry.