NPIMap

Organization Active NPI

Jeffrey Leider MD PLLC

Doing business as OnHealthcare Audiology

  • Audiologist
  • Ft Wright, KY
National Provider Identifier
1902175318
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0548 Issued in KY
Legal business name
JEFFREY LEIDER MD PLLC
Doing business as
OnHealthcare Audiology
Practice address
35 Augusta Ave
Ft Wright, KY 41011-3603
Phone
(248) 528-1981
Fax
(248) 528-1981
NPI assigned
Dec 14, 2011
Last updated
Oct 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Authorized official

Name
Dr. Jeffrey S Leider, MDNPI 1548259641
Title
Clinical Director
Phone
(248) 528-1981

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0548 KY Primary

Addresses

Primary practice location

35 Augusta Ave
Ft Wright, KY 41011-3603

Mailing address

1200 Kirts Blvd
Suite 200
Troy, MI 48084-4899
Phone (248) 528-1981

Other identifiers 1

IdentifierTypeStateIssuer
7100193700MedicaidKY

Other names 1

  • OnHealthcare Audiology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120315000730 KY Part B Supplier - Clinic/Group Practice 0941469621 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
Practice locations: Ft Wright, KY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jefferey S Leider MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445385600000",
    "number": "1902175318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 KIRTS BLVD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844899",
            "telephone_number": "248-528-1981",
            "fax_number": "248-528-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 AUGUSTA AVE",
            "city": "FT WRIGHT",
            "state": "KY",
            "postal_code": "410113603",
            "telephone_number": "248-528-1981",
            "fax_number": "248-528-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY LEIDER MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2015-10-21",
        "status": "A",
        "authorized_official_last_name": "LEIDER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "248-528-1981",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "0548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100193700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OnHealthcare Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ft Wright, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.