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DR. LEAH RUTH BLICKENSDERFER DO
NPI 1538914833
Student in an Organized Health Care Education/Training Program in South Bend, IN

Active since April 19, 2024PECOS Enrolled
714 N MICHIGAN ST, SOUTH BEND, IN 46601(574) 647-7477 Get Directions Write a Review

NPPES record last updated: April 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Leah Ruth Blickensderfer Do NPPES

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

DR. LEAH RUTH BLICKENSDERFER DO (NPI 1538914833) is an individual student in an organized health care education/training program in South Bend, Indiana and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1538914833
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. LEAH RUTH BLICKENSDERFERCredential: DO
Location Address714 N MICHIGAN STSouth Bend, IN 46601-1035
Mailing Address714 N Michigan StSouth Bend, IN 46601-1035
Phone(574) 647-7477
Sole ProprietorNo
Enumeration DateApril 19, 2024
NPPES CertifiedApril 19, 2024
✔ NPI 1538914833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
714 N MICHIGAN ST, South Bend, IN 46601
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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. Leah Ruth Blickensderfer Do 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.

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.

DR. DAVID HENRY TALARICO MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ABIGAIL LEIGH REESE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
DALE ALAN PATTERSON M.D.
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
MATTHEW T. DUPRE MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
RICHARD J. WARD MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
VICTORIA ANN BAWEL MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ISAAC D HATTON MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7913
LAURA LAWRENCE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477

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 Leah Blickensderfer's NPI number?

The NPI number for Leah Blickensderfer is 1538914833. It was assigned to this individual provider in the NPPES registry on April 19, 2024.

Where is Leah Blickensderfer located?

Leah Blickensderfer practices at 714 N Michigan St, South Bend, IN 46601. The listed phone number is (574) 647-7477.

What is Leah Blickensderfer's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Leah Blickensderfer enrolled in Medicare?

Yes. Leah Blickensderfer is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Leah Blickensderfer was last updated on April 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.