Active NPI
Benjamin Simon Leader, M.D., PH.D.
- Emergency Medicine Physician
- Woburn, MA
National Provider Identifier
1902185341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- LR22968-24196-LP0022
- Practice address
- 300 Tradecenter
Reprosource Inc. Suite 6540
Woburn, MA 01801-1883 - Phone
- (617) 312-8659
- Fax
- (617) 507-8446
- NPI assigned
- Aug 16, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | LR22968-24196-LP0022 | RI | Primary |
Addresses
Primary practice location
300 Tradecenter
Reprosource Inc. Suite 6540
Woburn, MA 01801-1883
Mailing address
300 Tradecenter
Reprosource Inc. Suite 6540
Woburn, MA 01801-1883
Phone (617) 312-8659
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)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LR22968-24196-LP0022 | RI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reprosource Fertility Diagnostics, Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Clinical Medical Laboratory
- Marlborough, MA
- NPI 1003078403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313452800000",
"number": "1902185341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 TRADECENTER",
"address_2": "REPROSOURCE INC. SUITE 6540",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011883",
"telephone_number": "617-312-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 TRADECENTER",
"address_2": "REPROSOURCE INC. SUITE 6540",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011883",
"telephone_number": "617-312-8659",
"fax_number": "617-507-8446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEADER",
"first_name": "BENJAMIN",
"middle_name": "SIMON",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-08-16",
"last_updated": "2011-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "RI",
"license": "LR22968-24196-LP0022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.