Individual provider Active NPI

Leelia Franck, M.D.

  • Family Medicine Physician
  • Santa Cruz, CA
National Provider Identifier
1033276696
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A121957 Issued in CA
Practice address
850 Front St
Santa Cruz, CA 95061-2001
Phone
(508) 340-6475
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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 A121957 CA Primary

Addresses

Primary practice location

850 Front St
Santa Cruz, CA 95061-2001

Mailing address

595 Hillcrest Dr
Felton, CA 95018-9121
Phone (508) 340-6475

Other identifiers 1

IdentifierTypeStateIssuer
2156369MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180215002315 CA Order and Referring Only - Family PracticePractitioner - Family Practice 1951477983

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121957CAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1033276696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 HILLCREST DR",
            "city": "FELTON",
            "state": "CA",
            "postal_code": "950189121",
            "telephone_number": "508-340-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 FRONT ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950612001",
            "telephone_number": "508-340-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANCK",
        "first_name": "LEELIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2023-12-27",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A121957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2156369",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.