LEO PASSOV (NPI# 1437359882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437359882 |
| Entity Type | Individual |
| Full Name | LEO PASSOV |
| Credential | MD |
| Practice Address |
2414 Kohler Memorial Dr Sheboygan WI 53081 |
| Mailing Address |
3833 Coon Rapids Blvd Suite 120 Coon Rapids MN 55433-2599 |
| Practice Telephone | 9204574461 |
| Mailing Telephone | 7637673350 |
| Mailing Fax Number | 7637670912 |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2018-08-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
57535-20 | WI | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
50942 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | ENROLLED | 05 | |
| WI | 35353800 | 05 | |
| IA | ENROLLED | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2414 Kohler Memorial Dr, Sheboygan, WI 530813129 | 9204574461 |
| Street Address |
2414 KOHLER MEMORIAL DR |
| City | SHEBOYGAN |
| State | WI |
| Zip Code | 53081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568461481 | Tracey N Aukerman | Audiologist | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2005-07-21 |
| 1124659420 | Geoffrey Wein | Pharmacist | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2020-01-27 |
| 1154961050 | Stephanie L Holschbach | Nurse Practitioner | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2020-01-09 |
| 1104460872 | Amy C Konkol | Physical Therapist | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2019-11-05 |
| 1891346672 | Matthew Paul Buch | Physical Therapist | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2019-09-24 |
| 1073166518 | Molly E Jorde | Dietitian, Registered | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2019-07-23 |
| 1215419544 | Jayson A Haan | Occupational Therapist | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2018-09-04 |
| 1841779238 | Michelle Zapinski | Registered Nurse | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2018-08-07 |
| 1023502192 | Christine Joel Debruine | Registered Nurse | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2018-06-21 |
| 1780177675 | Mallory Florence Andrews | Optometrist | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2018-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770053696 | Kathy Hughes Counseling, LLC | Community/Behavioral Health | 630 Riverfront Dr Ste 203, Sheboygan, WI 53081 | 2018-12-04 |
| 1780159004 | Great Lakes Clinic and Consultants, LLC | Clinic/Center | 1407 North 8th Street, Suite 203, Sheboygan, WI 53081 | 2018-10-13 |
| 1174032106 | Laura Elizabeth Manning | Registered Nurse | 325 Linocln Ave, Sheboygan, WI 53081 | 2017-09-21 |
| 1043733686 | Chasidy D Wilke | Behavioral Analyst | 2223 Terrace View Dr Apt 3a, Sheboygan, WI 53081 | 2017-07-25 |
| 1700320074 | Darlene Wilken | Counselor | 2842 S. Business Dr, Sheboygan, WI 53081 | 2016-12-06 |
| 1942652185 | Jacob Steven Son | Dentist | 3555 Wasington Ave., Sheboygan, WI 53081 | 2016-07-12 |
| 1225491749 | Cassandra Lea Loehndorf | Social Worker | 3321 S. 12th St., Sheboygan, WI 53081 | 2016-04-01 |
| 1003201112 | Jason Meinhardt | Dentist | 2115 S Memorial Pl, Sheboygan, WI 53081 | 2015-04-06 |
| 1346634110 | Christopher Lenz | Specialist/Technologist | 2920 Superior Ave., Prevea Orthopedics, Sheboygan, WI 53081 | 2015-03-19 |
| 1780008060 | James Simac | Counselor | 503 Wisconsin Ave., Sheboygan, WI 53081 | 2014-02-07 |
| Find all providers in zip 53081 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598789547 | Daniel W. Knoedler | Psychiatry & Neurology | 1807 Ridge Rd, Sheboygan, WI 53083-2148 | 2006-07-26 |
| 1205262094 | Eiman Qureshi | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2013-09-24 |
| 1700220167 | Niharika Kunapuli | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2013-04-29 |
| 1336418714 | Lkg, LLC | Psychiatry & Neurology | 3425 Superior Ave, Sheboygan, WI 53081-1863 | 2011-12-14 |
| 1043465263 | Ahmed Javed | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081-3129 | 2008-12-02 |
| 1033389085 | John Leo Olsen | Psychiatry & Neurology | 3425 Superior Ave, Sheboygan, WI 53081-1863 | 2008-03-06 |
| 1285741728 | Stephen J Krummel | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2006-08-23 |
| 1992812366 | Clint A Norris | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2006-08-23 |
| 1265547434 | Edmund C Dy | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2006-08-20 |
| 1245345230 | Suzanne B Grimm | Psychiatry & Neurology | 2414 Kohler Memorial Dr, Sheboygan, WI 53081 | 2006-08-20 |
| Find all providers in SHEBOYGAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.