MEDICARE: LEANNE K BEIDLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD061485L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1114565	OTHER	PA	AETNA HMO
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P006207	OTHER	PA	GATEWAY HEALTH PLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	G61167	OTHER	PA	HEALTH AMERICA
6	P006207	OTHER	PA	GEISINGER HEALTH PLAN
7	50038640	OTHER	PA	CAPITAL BLUE CROSS
8	5061535	OTHER	PA	AETNA NON-HMO

General Provider Information

NPI Number	:	1275528655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEANNE K BEIDLER M.D.

Provider Business Mailing Address
First Line	:	222 WILLOW VALLEY LAKES DR
Second Line	:	STE 400
City	:	WILLOW STREET
State	:	PA
Zip	:	17584-9671
Country	:	US
Telephone Number	:	717-544-8694
Fax Number	:	717-544-8695

Provider Business Practice Location Address
First Line	:	222 WILLOW VALLEY LAKES DR
Second Line	:	STE 400
City	:	WILLOW STREET
State	:	PA
Zip	:	17584-9671
Country	:	US
Telephone Number	:	717-544-8694
Fax Number	:	717-544-8695

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	03/03/2026

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