Adam Leestma, FNP
Individual provider Active NPI Family Nurse Practitioner · Demotte, IN
NPI 1891230140 · NPPES record last updated Dec 22, 2016
Key facts
- NPI
- 1891230140
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 28199079A (IN)
- Practice address
- 519 N Halleck St
Demotte, IN 46310-9553 - Phone
- (219) 987-7750
- Fax
- (219) 987-5750
- NPI assigned
- Dec 22, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Leestma Medical Clinic, Inc
Practice addresses (Care Compare)
519 N Halleck St
Demotte, IN 46310-9553
Phone (219) 987-7750
Hospital & facility affiliations
- Franciscan Home Care
- Northwestern Medicine Central Dupage Hospital
- Pinnacle Hospital
- Franciscan Health Crown Point
- Franciscan Health Rensselaer, Inc
- Northwest Health - Porter
- Powers Health Rehabilitation Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170327001651 | IN | Practitioner - Nurse Practitioner | 0840575213 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28199079A | IN | MD | Family Nurse Practitioner |
Interoperability endpoints
- adam.leestma.1@21537.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28199079A | IN | Yes |
Addresses
Primary practice location
519 N Halleck St
Demotte, IN 46310-9553
Mailing address
519 N Halleck St
Demotte, IN 46310-9553
Phone (219) 987-7750
Other providers in Demotte, IN
- Koveck Family Dentistry LLC
- Lake Holiday Drugs Inc
- Laura Louise Langel
- Larry W. Pampel D.D.S., Inc.
- Leestma Medical Clinic, Inc
- Eric J Leestma
- Micah James Leestma
- Cheryle Rae Lewandowski
- Little Green Thumbs ABA LLC
- Daron Keith Lynch
All providers in Demotte, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.