DR. NICKY JO LEEBORG M.D.
NPI 1790921005
Student in an Organized Health Care Education/Training Program in Portland, OR
NPI Status: Active since December 17, 2008
Contact Information
3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 494-2310
- Individual
- Female
- Years of Experience 23
- Student in an Organized Health Care Educ...
- Accepts Medicare Approved Payment
- PECOS Enrolled
About NICKY LEEBORG
This page provides the complete NPI Profile along with additional information for Nicky Leeborg, a primary care provider established in Portland, Oregon with a medical specialization in Student In An Organized Health Care Education/training Program and more than 23 years of experience. She graduated from State University Of Ny Upstate Medical University in 2003. The healthcare provider is registered in the NPI registry with number 1790921005 assigned on December 2008. The practitioner's primary taxonomy code is 390200000X with license number MD27627 (OR). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1790921005
- Provider Name
- DR. NICKY JO LEEBORG M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3181 SW SAM JACKSON PARK RD PORTLAND, OR 97239
- Location Phone
- (503) 494-2310
- Mailing Address
- 3181 SW SAM JACKSON PARK RD PORTLAND, OR 97239
- Mailing Phone
- (503) 494-2310
- Medical School Name
- STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
- Graduation Year
- 2003
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-17-2008
- Last Update Date
- 02-01-2022
- Code Navigator
A primary care provider (PCP) like Nicky Leeborg sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Student in an Organized Health Care Education/Training Program
- Taxonomy Code
- 390200000X
- Type
- Student, Health Care
- License No.
- MD27627
- License State
- OR
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
Nicky Leeborg is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Nicky Leeborg is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 42366676
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20090922000784
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1790921005, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1790921005, enumerated as an "individual" on December 17, 2008.
The provider is located at 3181 SW SAM JACKSON PARK RD PORTLAND, OR 97239 and the phone number is (503) 494-2310.
Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
