Individual provider Active NPI

Karla Fitzgerald Leavens, M.D., PH.D.

  • Pediatric Endocrinology Physician
  • Philadelphia, PA
National Provider Identifier
1043576424
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
MT201497 Issued in PA
Practice address
3401 Civic Center Blvd
Division of Pediatric Endocrinology
Philadelphia, PA 19104-4319
Phone
(215) 694-8998
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X MT201497 PA Primary

Addresses

Primary practice location

3401 Civic Center Blvd
Division of Pediatric Endocrinology
Philadelphia, PA 19104-4319

Mailing address

2115 South St
Apt #204
Philadelphia, PA 19146-1223
Phone (215) 694-8998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180612002714 PA Practitioner - Endocrinology 6002161254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Perelman School of Med at the University of Pennsylvania, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Health Care Associates IncGroup PAC ID 1355253527, 211 clinicians

Practice addresses (Care Compare)

3401 Civic Ctr Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT201497PAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Current Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Jun 1, 2018 Accepting new patients
Childrens Health Care Associates, Inc Pediatric Endocrinology CurrentSince Jun 1, 2018 Accepting new patients
Childrens Hospital of Philadelphia Past Accepting new patients
Childrens Health Care Associates of New Jersey PC Past Accepting new patients

Locations

3500 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-2169

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 5

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1043576424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 SOUTH ST",
            "address_2": "APT #204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461223",
            "telephone_number": "215-694-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "address_2": "DIVISION OF PEDIATRIC ENDOCRINOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-694-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVENS",
        "first_name": "KARLA",
        "middle_name": "FITZGERALD",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "PA",
            "license": "MT201497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.