Provider Demographics
NPI:1801143367
Name:LEINBACH, LINDSEY RAE (FNP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE
Last Name:LEINBACH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:RAE
Other - Last Name:KATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:129 W 29TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5105
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:
Practice Address - Street 1:408 W 14TH ST STE 201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014
Practice Address - Country:US
Practice Address - Phone:212-530-0639
Practice Address - Fax:212-867-4353
Is Sole Proprietor?:No
Enumeration Date:2012-08-14
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704260932163W00000X, 363LF0000X
NY338176163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01246059Medicaid
NY00695941Medicaid
NY331058Medicare Oscar/Certification
NY331947Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY571000Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY571056Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY01246059Medicaid
NY331496Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification