Amanda Leisenheimer, RD is a medicare enrolled "Dietitian, Registered" provider in Lake City, Minnesota. Her current practice location is
500 W Grant St, Lake City, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(651) 345-1187.
Amanda Leisenheimer is licensed to practice in Minnesota (license number 994439) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1801264742.
Healthcare Provider's Profile
| Full Name | Amanda Leisenheimer |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 500 W Grant St, Lake City, Minnesota |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1801264742
- Provider Enumeration Date: 09/09/2015
- Last Update Date: 09/29/2020
Medicare PECOS Information:
- PECOS PAC ID: 6800144072
- Enrollment ID: I20180803000898
Medical Identifiers
Medical identifiers for Amanda Leisenheimer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801264742 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 994439 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Leisenheimer allows following entities to bill medicare on her behalf.
| Provider Name | Mayo Clinic Health System-lake City |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1164463659
PECOS PAC ID: 1951213487
Enrollment ID: O20031104000095 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Leisenheimer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Amanda Leisenheimer, RD
4502 August Way,
Inver Grove Heights, MN 55077-1305
Ph: (952) 270-6931 | Amanda Leisenheimer, RD
500 W Grant St,
Lake City, MN 55041-1143
Ph: (651) 345-1187 |
Reviews and Comments