Active NPI
Marylen Leon
- Family Nurse Practitioner
- East Hampton, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F346034
- Practice address
- 470 Pantigo Rd
East Hampton, NY 11937-2648 - Phone
- (631) 702-0212
- NPI assigned
- Aug 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F346034 | NY | Primary |
Addresses
Primary practice location
470 Pantigo Rd
East Hampton, NY 11937-2648
Mailing address
PO Box 2206
Sag Harbor, NY 11963-0111
Phone (631) 702-0212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Miller PL
Smithtown, NY 11787-3629
Phone (631) 604-4024
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F346034 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meeting House Lane Medical Practice PC | Current | Accepting new patients | |
| Medical Office of Doctor Ilona K Polak PC | Current | Accepting new patients |
Locations
470 Pantigo Rd
East Hampton, NY 11937
Phone (631) 329-5900
34 Bay St
#103
Sag Harbor, NY 11963
Phone (631) 537-1892
57 Hampton Rd
Ste 201
Southampton, NY 11968
Phone (631) 283-1126
325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100
Interoperability endpoints
- marylen.leon.p1@direct.shproviders.nextgenshare.com
Organizations & group practices 3
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.
-
- Urgent Care Clinic/Center
- Rockville Centre, NY
- NPI 1679970891
-
- Family Medicine Physician
- Sag Harbor, NY
- NPI 1699058958
-
- Internal Medicine Physician
- Southampton, NY
- NPI 1902088495
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1053087619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2206",
"city": "SAG HARBOR",
"state": "NY",
"postal_code": "119630111",
"telephone_number": "631-702-0212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 PANTIGO RD",
"city": "EAST HAMPTON",
"state": "NY",
"postal_code": "119372648",
"telephone_number": "631-702-0212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "MARYLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-23",
"last_updated": "2021-08-23",
"certification_date": "2021-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F346034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Hampton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.