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DR. LEO JAN BASTIAENS M.D.
NPI 1235127754
Psychiatry & Neurology - Child & Adolescent Psychiatry in Brewster, NY

Active since October 10, 2005PECOS Enrolled
1620 ROUTE 22 STE 203, BREWSTER, NY 10509(845) 278-2500(844) 454-5096 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 6, 2022, May 30, 2020 (2 updates tracked since 2020).

About Dr. Leo Jan Bastiaens M.d. NPPES

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

DR. LEO JAN BASTIAENS M.D. (NPI 1235127754) is an individual child & adolescent psychiatry provider in Brewster, New York, licensed in New York (171146) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235127754
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. LEO JAN BASTIAENSCredential: M.D.
Location Address1620 ROUTE 22 STE 203Brewster, NY 10509-4052
Mailing Address366 Heritage Hls Unit ASomers, NY 10589-4048 · (412) 334-3393 · Fax (844) 454-5096
Phone(845) 278-2500
Fax(844) 454-5096
Sole ProprietorYes
Enumeration DateOctober 10, 2005
Last NPPES UpdateApril 6, 20222 updates tracked since enumeration
NPPES CertifiedApril 6, 2022
✔ NPI 1235127754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in NY · 171146
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
1620 ROUTE 22 STE 203, Brewster, NY 10509
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Other Identifiers 1

Medicaid06049783NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Leo Jan Bastiaens M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leo Bastiaens's NPI number?

The NPI number for Leo Bastiaens is 1235127754. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Where is Leo Bastiaens located?

Leo Bastiaens practices at 1620 Route 22 Ste 203, Brewster, NY 10509. The listed phone number is (845) 278-2500.

What is Leo Bastiaens's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Leo Bastiaens enrolled in Medicare?

Yes. Leo Bastiaens is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leo Bastiaens was last updated on April 6, 2022. 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.