Individual provider Active NPI

Alicia Leedy, MD

  • Pediatrics Physician
  • Carmel, IN
National Provider Identifier
1902810831
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01047074A Issued in IN
Practice address
11911 N Meridian St
Suite 180
Carmel, IN 46032-6904
Phone
(317) 621-6888
Fax
(317) 621-6886
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01047074A IN Primary

Addresses

Primary practice location

11911 N Meridian St
Suite 180
Carmel, IN 46032-6904

Mailing address

6626 E. 75TH Street
Suite 500
Indianapolis, IN 46250-2890

Other identifiers 2

IdentifierTypeStateIssuer
200240200MedicaidIN
000000319536OtherINANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aleedy10609@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110329000002 IN Practitioner - Pediatric Medicine 5092998013 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047074AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Physicians of Indiana Inc CurrentSince Apr 20, 2011 Accepting new patients
Community Physicians of Indiana Inc Pediatrics CurrentSince Apr 20, 2011 Accepting new patients
Major Hospital Past Accepting new patients
Riverview Hospital Pediatrics Past Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

11911 N Meridian St
Ste 180
Carmel, IN 46032
Phone (317) 621-6888

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

Interoperability endpoints

  • Direct secure messaging: aleedy10609@ecommunitydirect.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1902810831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E. 75TH STREET",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 N MERIDIAN ST",
            "address_2": "SUITE 180",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326904",
            "telephone_number": "317-621-6888",
            "fax_number": "317-621-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEDY",
        "first_name": "ALICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01047074A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200240200",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000319536",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aleedy10609@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "11911 N Meridian St",
            "address_2": "Suite 180",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460326904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.