LIANE J LEEDOM (M.D.) – Psychiatry Physician, NPI 1063702595

LIANE J LEEDOM (M.D.) is a healthcare provider. based in Trumbull, Connecticut. specializing in PSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. 31647 (CT). The NPI Number for LIANE J LEEDOM (M.D.) is 1063702595

Main info

Female
39 Years Of Experience
Accepts Medicare Assignment
Name
LIANE J LEEDOM (M.D.)
NPI
1063702595
Phone
(203) 615-1633
Address
140 OLD DIKE RD
Enumeration Date
18 April 2011
Last Update Date
18 April 2011

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Secondary Phone
8607364140
Graduation Year
1987 (39 years ago)
PAC ID
8729037502
Group Practice PAC ID
1951692706
Professional Enrollment ID
I20050119000551
Address ID
CT060672328RO2257XHWYX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

851 PSYCHIATRY in CT

Provider Addresses for LIANE J LEEDOM (M.D.)

  • 140 OLD DIKE RD

    TRUMBULL, CT 066113334

    Phone: (203) 615-1633

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-01-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050119000551IPsychiatryCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06611)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951692706View full group profile
NameSpecialtyState
Nurse PractitionerCT
A N E S T H E S I O L O G YCT
Clinical Social WorkerCT
Psychiatry, Geriatric PsychiatryCT
-CT
Nurse PractitionerCT
Nurse PractitionerCT

Reviews

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Frequently asked questions

Does LIANE J LEEDOM (M.D.) have a public NPI I can cite?
Public records show LIANE J LEEDOM (M.D.) under NPI 1063702595.
Should I treat LIANE J LEEDOM (M.D.) as an active provider?
Patients and plans typically see LIANE J LEEDOM (M.D.) as active in the national extract.
What services align with LIANE J LEEDOM (M.D.)'s listing?
LIANE J LEEDOM (M.D.)'s public classification highlights Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to LIANE J LEEDOM (M.D.)?
LIANE J LEEDOM (M.D.) shows a connection to Trumbull, Connecticut in registry-derived data.
Can I export LIANE J LEEDOM (M.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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