Tracy Leong, MD
Individual provider Active NPI Dermatology Physician · Riverside, CA
NPI 1003133216 · NPPES record last updated Apr 15, 2025
Key facts
- NPI
- 1003133216
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- A119718 (CA)
- Practice address
- 7160 Brockton Ave FL 2
Riverside, CA 92506-2614 - Phone
- (951) 782-3837
- Fax
- (951) 328-9758
- NPI assigned
- Apr 27, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Dermatology
- Education
- Loma Linda University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Riverside Medical Clinic Inc
Practice addresses (Care Compare)
7160 Brockton Ave
FL 2
Riverside, CA 92506-2614
Phone (951) 782-5110
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 194 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 71 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130805000801 | CA | Practitioner - Dermatology | 5799927679 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (8 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaver Medical Group P C | Dermatology | Current |
Accepting new patients |
| Csi Medical Group | Dermatology | Current |
Accepting new patients |
| Beaver Medical Group P C | Current |
Accepting new patients | |
| Riverside Medical Clinic, Inc | Current |
Accepting new patients | |
| Riverside Medical Clinic, Inc | Dermatology | Current | Accepting new patients |
| Riverside Medical Clinic, Inc | Dermatology | Current |
Accepting new patients |
| Mendota Community Hospital | Past | Accepting new patients | |
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Locations
2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137
2 W Fern Ave
#1112
Redlands, CA 92373
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789
7160 Brockton Ave
Fl 2
Riverside, CA 92506
Phone (951) 782-3837
21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157
1934 Via Ctr
Ste B
Vista, CA 92081
Phone (760) 295-2299
2395 S Melrose Dr
Vista, CA 92081
Phone (760) 216-5313
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A119718 | CA | Yes |
Addresses
Primary practice location
7160 Brockton Ave FL 2
Riverside, CA 92506-2614
Mailing address
7160 Brockton Ave FL 2
Riverside, CA 92506-2620
Phone (951) 782-3837
Other practice location 1
21634 Retreat Pkwy
Corona, CA 92883-6100
Phone (951) 493-6827
Other providers in Riverside, CA
- Grace Leonard
- Rebecca Galler Leonardo
- Melissa Leone
- Benjamin Leong
- Rachel Leong
- Salyne Leos
- Talolo Tua Lepale Jr.
- Apolonia N Lepe
- Bernardo Lepe Jr.
- Kailea Lesaca
All providers in Riverside, CA · Dermatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.