Individual provider Active NPI

Raphael Jerome Leo, MD

  • Specialist
  • Buffalo, NY
National Provider Identifier
1063488062
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
185977 Issued in NY
Practice address
462 Grider St
Buffalo, NY 14215-3021
Phone
(716) 898-4857
Fax
(716) 898-3986
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 185977 NY Primary

Addresses

Primary practice location

462 Grider St
Buffalo, NY 14215-3021

Mailing address

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-4857

Other identifiers 1

IdentifierTypeStateIssuer
01604737MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329000036 NY Practitioner - PsychiatryPractitioner - Pain Management 7012043102 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Pain Management
Education
State University of New York at Buffalo School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaleida HealthGroup PAC ID 7810805280, 214 clinicians
Erie County Medical Center CorporationGroup PAC ID 1456308907, 316 clinicians
University Psychiatric Practice IncGroup PAC ID 3375442056, 11 clinicians

Practice addresses (Care Compare)

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

445 Tremont St
North Tonawanda, NY 14120-6150
Phone (716) 694-4500

462 Grider St
Buffalo, NY 14215-3021
Phone (716) 898-3000

Hospital & facility affiliations

  • Erie County Medical Center Hospital, Buffalo, NY, CCN 330219
  • Kaleida Health Hospital, Buffalo, NY, CCN 330005

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
80.2
Improvement activities
40
Cost
72.88

Merit-based Incentive Payment System (MIPS)

Final score
99.06 of 100Reported as group
Quality
87.72
Promoting interoperability
100
Improvement activities
40
Cost
75.82

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185977NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health Current Accepting new patients
North Gate Health Care Facility LLC CurrentSince Jan 16, 2010 Accepting new patients
Seneca Health Care Center LLC CurrentSince Jan 16, 2010 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Kaleida Health CurrentSince Feb 1, 2002 Accepting new patients
University Psychiatric Practice, Inc CurrentSince Jul 1, 1995 Accepting new patients
Autumn View Health Care Facility LLC CurrentSince Jan 16, 2010 Accepting new patients
Kaleida Health CurrentSince Feb 1, 2002 Accepting new patients
Harris Hill Nursing Facility, LLC CurrentSince Jan 16, 2010 Accepting new patients
Garden Gate Health Care Facility LLC CurrentSince Jan 16, 2010 Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

462 Grider St
Rm 1168
Buffalo, NY 14215
Phone (716) 898-4857

560 Delaware Ave
Rm 400
Buffalo, NY 14202
Phone (716) 324-5100

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

2365 Union Rd
Cheektowaga, NY 14227
Phone (716) 668-8100

455 Cayuga Rd
Ste 200
Cheektowaga, NY 14225

4650 Southwestern Blvd
Hamburg, NY 14075
Phone (716) 648-2450

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

7264 Nash Rd
North Tonawanda, NY 14120
Phone (716) 694-7700

2987 Seneca St
West Seneca, NY 14224
Phone (716) 652-1560

2699 Wehrle Dr
Williamsville, NY 14221
Phone (716) 631-8863

Organizations & group practices 11

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 7

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063488062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-4857",
            "fax_number": "716-898-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 GRIDER ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142153021",
            "telephone_number": "716-898-4857",
            "fax_number": "716-898-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "RAPHAEL",
        "middle_name": "JEROME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "185977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01604737",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.