Randall Mark Leja, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101019817 Issued in MI

Practice address

100 Michigan St NE # 13
Grand Rapids, MI 49503-2560

Phone

(616) 267-0073

NPI assigned

Jun 18, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Forest Hills Pediatric Associates, PC

  • Pediatrics Physician
  • Grand Rapids, MI
  • NPI 1699767343
  NPD (past)

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1891058624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 BOND AVE NW APT 402",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495036705",
            "telephone_number": "517-740-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # 13",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-267-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEJA",
        "first_name": "RANDALL",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101019817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Leipham, PHARMD
• Joy Leise, LMSW
• Rachel Maye Leitner
• Carolyn E Leja, CNM
• Christopher John Leja, DMD
• Elizza Brittany Lejeune, LMSW
• Leland D. Zuidema DDS P.C.
• Nicole Teresa Leland
• Theresa Ann Lemieur, CRNA
• Hannah Lemke

• Pediatrics Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.