Individual provider Active NPI

Erick Leffler, D.C.

  • Chiropractor
  • Syracuse, IN
National Provider Identifier
1891066189
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002619A Issued in IN
Practice address
201 E Palm Dr Ste E
Syracuse, IN 46567
Phone
(574) 457-7472
Fax
(574) 457-7103
NPI assigned
Jan 19, 2012
Last updated
Mar 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002619A IN Primary

Addresses

Primary practice location

201 E Palm Dr Ste E
Syracuse, IN 46567

Mailing address

PO Box 91
Syracuse, IN 46567-0091
Phone (574) 457-7472

Other identifiers 1

IdentifierTypeStateIssuer
201051710MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120312000504 IN Practitioner - Chiropractic 7618136649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Dynamic Spine and Rehabilitation CenterGroup PAC ID 9537328554, 2 clinicians

Practice addresses (Care Compare)

106 E Pickwick Dr
Syracuse, IN 46567-1713
Phone (574) 457-7472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08002619AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Spine and Rehabilitation Center Chiropractor CurrentSince Mar 1, 2012 Accepting new patients

Locations

106 E Pickwick Dr
Syracuse, IN 46567
Phone (574) 216-1839

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1891066189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91",
            "city": "SYRACUSE",
            "state": "IN",
            "postal_code": "465670091",
            "telephone_number": "574-457-7472",
            "fax_number": "574-457-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E PALM DR STE E",
            "city": "SYRACUSE",
            "state": "IN",
            "postal_code": "46567",
            "telephone_number": "574-457-7472",
            "fax_number": "574-457-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFFLER",
        "first_name": "ERICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002619A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201051710",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.