Individual provider Active NPI

Boris J Leheta, MD

  • Neurology Physician
  • Roseville, MI
National Provider Identifier
1891724894
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
BL049688 Issued in MI
Practice address
25100 Kelly Rd
Roseville, MI 48066-4910
Phone
(586) 771-7440
Fax
(586) 771-9966
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X BL049688 MI Primary

Addresses

Primary practice location

25100 Kelly Rd
Roseville, MI 48066-4910

Mailing address

25100 Kelly Rd
Roseville, MI 48066-4910
Phone (586) 771-7440

Other identifiers 1

IdentifierTypeStateIssuer
3389375MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BL049688MIMDNeurology Physician

Interoperability endpoints

  • Direct secure messaging: bleheta57315@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1891724894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25100 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664910",
            "telephone_number": "586-771-7440",
            "fax_number": "586-771-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25100 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664910",
            "telephone_number": "586-771-7440",
            "fax_number": "586-771-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHETA",
        "first_name": "BORIS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "BL049688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3389375",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.