Individual provider Active NPI

Jim C Leung, MD

  • Family Medicine Physician
  • Tamarac, FL
National Provider Identifier
1003992173
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME97201 Issued in FL
Practice address
7171 N University Dr
Suite 203
Tamarac, FL 33321-2902
Phone
(954) 721-4300
Fax
(954) 721-8080
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME97201 FL Primary

Addresses

Primary practice location

7171 N University Dr
Suite 203
Tamarac, FL 33321-2902

Mailing address

7171 N University Dr
Suite 203
Tamarac, FL 33321-2902
Phone (954) 721-4300

Other identifiers 2

IdentifierTypeStateIssuer
90871OtherBC/BS FLORIDA
305160OtherAVMED

Other names 1

  • Jim C Leung Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070629000286 FL Practitioner - Family Practice 6406955509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME97201FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Solutions Inc CurrentSince Jun 18, 2013 Accepting new patients

Locations

5430 NW 33rd Ave
Ste 106
Ft Lauderdale, FL 33309
Phone (877) 884-8277

255 E 5th St
Ste 1050
Cincinnati, OH 45202

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1003992173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 N UNIVERSITY DR",
            "address_2": "SUITE 203",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212902",
            "telephone_number": "954-721-4300",
            "fax_number": "954-721-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 N UNIVERSITY DR",
            "address_2": "SUITE 203",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212902",
            "telephone_number": "954-721-4300",
            "fax_number": "954-721-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "JIM",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS FLORIDA",
            "identifier": "90871",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "305160",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIM",
            "last_name": "LEUNG",
            "middle_name": "C",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tamarac, FL

Sources for this page

Verify at the official NPI Registry.