Individual provider Active NPI

Mary Elizabeth Leone, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1033689153
Registry record updated Dec 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201807354NP-PP Issued in OR
Practice address
1132 SW 13TH Ave
Portland, OR 97205-1703
Phone
(503) 535-3800
NPI assigned
Dec 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201807354NP-PP OR Primary

Addresses

Primary practice location

1132 SW 13TH Ave
Portland, OR 97205-1703

Mailing address

970 Quay Ave Apt B
Grandview, OH 43212-3755
Phone (440) 476-0240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190725003640 OR Practitioner - Nurse Practitioner 3779819917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

39740 Pleasant St
Sandy, OR 97055-6412
Phone (503) 655-8471

9775 SE Sunnyside Rd
Suite 200
Clackamas, OR 97015-5721
Phone (503) 655-8471

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201807354NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clackamas County Current Accepting new patients
County of Clackamas Office of County Auditor CurrentSince Aug 20, 2020 Accepting new patients

Locations

9775 SE Sunnyside Rd
Ste 200
Clackamas, OR 97015
Phone (503) 794-3830

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

39740 Pleasant St
Sandy, OR 97055
Phone (503) 563-7679

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1543622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543622400000",
    "number": "1033689153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 QUAY AVE APT B",
            "city": "GRANDVIEW",
            "state": "OH",
            "postal_code": "432123755",
            "telephone_number": "440-476-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051703",
            "telephone_number": "503-535-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-01",
        "last_updated": "2018-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201807354NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.