Crystal Ivahna Leach, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

D0085741 Issued in MD

Practice address

17351 Melford Blvd
Bowie, MD 20715-4457

Phone

(240) 548-1300

Fax

(240) 548-1695

NPI assigned

Apr 16, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, GA, ID3 enrollments

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 3

Specialty

Physical Medicine and Rehabilitation

Education

Louisiana State University School of Medicine in New Orleans, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifepoint Rehab Physician Services LLCGroup PAC ID 3678932043, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028
• Portneuf Medical Center Inpatient rehabilitation facility, Pocatello, ID, CCN 13T028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: crystal.leach@direct.einstein.edu
• Direct secure messaging: cleach840803@ahs.direct-ci.com

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.

• Lifepoint Rehab Physician Services LLC

  • Physical Medicine & Rehabilitation Physician
  • Pocatello, ID
  • NPI 1598492522
  Medicare reassignment Care Compare group NPD
• Phoebe Physician Group, Inc

  • Clinic/Center
  • Albany, GA
  • NPI 1487899464
  Medicare reassignment NPD
• Wellstar MCG Health Warm Springs, Inc.

  • Rehabilitation Hospital
  • Warm Springs, GA
  • NPI 1760892657
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Lifepoint Rehab Physician Services LLC

  • Physical Medicine & Rehabilitation Physician
  • Billings, MT
  • NPI 1407542483
  NPD
• Wellstar MCG Health Warm Springs, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Warm Springs, GA
  • NPI 1952781759
  NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD

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

• Pocatello Hospital LLC

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1891115994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14640 GOVERNOR SPRIGG PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207725910",
            "telephone_number": "504-915-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17351 MELFORD BLVD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154457",
            "telephone_number": "240-548-1300",
            "fax_number": "240-548-1695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9211 Stuart Ln",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MD",
            "postal_code": "207352712",
            "country_code": "US",
            "telephone_number": "504-915-3461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "144 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Edgewater",
            "state": "MD",
            "postal_code": "210371412",
            "country_code": "US",
            "telephone_number": "504-915-3461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "CRYSTAL",
        "middle_name": "IVAHNA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "M-17056",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "95216",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "DC",
            "license": "MD046990",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D0085741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owolabi Lawal
• Dana Lawrence, MS, BCBA
• Scott Maclaren Lawrence, DDS
• Leslie Elizabeth J. Lawson, CRNP
• Oluwafunmike Tewogbola Layode
• Lean on Me Home Health Care, LLC
• Lilian Leanyuy
• Boniface Lebog
• Katherine A Ledon
• Sosamma Ledoux, NP

• Physical Medicine & Rehabilitation Physician in Bowie, MD
• Providers in Bowie, MD by specialty
• Physical Medicine & Rehabilitation Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.
• 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.