Active NPI
Thomas W Leither, MD
- Nephrology Physician
- Saint Cloud, MN
National Provider Identifier
1982694584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 26978
- Practice address
- 1200 6TH Ave N
Saint Cloud, MN 56303-2735 - Phone
- (320) 252-5131
- Fax
- (320) 240-2118
- NPI assigned
- Oct 25, 2005
- 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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 26978 | MN | Primary |
Addresses
Primary practice location
1200 6TH Ave N
Saint Cloud, MN 56303-2735
Mailing address
1200 6TH Ave N
Saint Cloud, MN 56303-2735
Phone (320) 252-5131
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2114022 | Other | FIRST HEALTH PLAN | |
| 3120409 | Other | MEDICA HEALTH PLANS | |
| 390003513 | Other | RR MEDICARE | |
| HP25474 | Other | HEALTH PARTNERS | |
| 3100290(PL) | Other | MEDICA HEALTH PLANS | |
| 986015 | Other | PREFERRED ONE | |
| 110905 | Other | U CARE | |
| CU0204 | Other | RR MEDICARE | |
| 600880 | Other | ARAZ GROUP AMERICAS PPO | |
| 6D072LE | Other | BLUE CROSS BLUE SHIELD | |
| 686508900 | Other | MEDICAL ASSISTANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26978 | MN | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients |
Locations
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
Interoperability endpoints
- tleither1398@direct.centracare.com
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- St Cloud, MN
- NPI 1043212665
-
- Occupational Medicine Clinic/Center
- Saint Cloud, MN
- NPI 1366192759
-
- Multi-Specialty Clinic/Center
- Baxter, MN
- NPI 1679025746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318377600000",
"number": "1982694584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032735",
"telephone_number": "320-252-5131",
"fax_number": "320-240-2118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 6TH AVE N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032735",
"telephone_number": "320-252-5131",
"fax_number": "320-240-2118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEITHER",
"first_name": "THOMAS",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-25",
"last_updated": "2011-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MN",
"license": "26978",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH PLAN",
"identifier": "2114022",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLANS",
"identifier": "3120409",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "390003513",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25474",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA HEALTH PLANS",
"identifier": "3100290(PL)",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "986015",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U CARE",
"identifier": "110905",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CU0204",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ GROUP AMERICAS PPO",
"identifier": "600880",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "6D072LE",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "686508900",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.