DR. LEESA RAE NOVOTNY MD
NPI 1225483563
Family Medicine in Montevideo, MN

Q: What is Leesa Novotny's NPI number?

The NPI number for Leesa Novotny is 1225483563. It was assigned to this individual provider in the NPPES registry on April 24, 2016. The provider is also known as Leesa Rae Larson.

Q: What is Leesa Novotny's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Leesa Novotny was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 24, 2016PECOS Enrolled

824 N 11TH ST, MONTEVIDEO, MN 56265(320) 269-8877(320) 269-8186 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 29, 2021, Aug 21, 2019, Jul 2, 2019 (3 updates tracked since 2019).

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About Dr. Leesa Rae Novotny Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LEESA RAE NOVOTNY MD (NPI 1225483563) is an individual family medicine provider in Montevideo, Minnesota, licensed in Minnesota (64617) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with St Cloud Hospital, and maintains a secondary practice location in Montevideo.

NPPES Registry Identity

NPI1225483563

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. LEESA RAE NOVOTNYCredential: MD

Location Address824 N 11TH STMontevideo, MN 56265

Mailing Address824 N 11th StMontevideo, MN 56265 · (320) 269-8877 · Fax (320) 269-8186

Phone(320) 269-8877

Fax(320) 269-8186

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateApril 24, 2016

Last NPPES UpdateDecember 29, 20213 updates tracked since enumeration

NPPES CertifiedDecember 29, 2021

✔ NPI 1225483563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MN · 64617

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

824 N 11TH ST, Montevideo, MN 56265

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Other Names 1

Former Name (1)Leesa Rae Larson

Secondary Practice Location 1

Location 11304 E Lincoln AveMontevideo, MN 56265-2019 · Phone (320) 339-2199

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Leesa Rae Novotny Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931480340

PECOS Enrollment IDI20190826002202

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Leesa Novotny reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ccm Health

1.2 mi

Urgent Care

824 N 11TH ST
Montevideo, MN 56265

Reassigned Medicare billing, Minnesota enrollment
Also billed through NPI 1720086028 (Minnesota)
149 clinicians in this Medicare group

NPI 1275057978 (320) 269-8877

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

43 services34 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Cloud Hospital

Acute Care Hospitals · Saint Cloud, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240036

Location1406 6th Ave NorthSaint Cloud, MN 56303 · Stearns County

Emergency services Birthing friendly

Chippewa County Hospital

Critical Access Hospitals · Montevideo, MN

OwnershipGovernment - Local

CMS Certification Number241325

Location824 North 11th StreetMontevideo, MN 56265 · Chippewa County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56265 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

1 supplier12 claims19 services$4.51 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers14 claims14 services$31.75 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers17 claims17 services$193.70 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

1 supplier11 claims11 services$38.18 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA MARIE SANDVEN CHW

Community Health Worker