Individual provider Active NPI

Patrick A Leonberger, D.O.

  • Internal Medicine Physician
  • Beaver Dam, WI
National Provider Identifier
1063823763
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
69793-21 Issued in WI
Practice address
707 S University Ave
Beaver Dam, WI 53916-3089
Phone
(314) 517-8214
NPI assigned
May 15, 2014
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036151501 IL
Internal Medicine Physician 207R00000X 69793-21 WI Primary

Addresses

Primary practice location

707 S University Ave
Beaver Dam, WI 53916-3089

Mailing address

707 S University Ave
Beaver Dam, WI 53916-3089
Phone (314) 517-8214

Other practice location 1

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

Other practice location 2

405 W Jackson St
Carbondale, IL 62901-1462
Phone (618) 549-0721

Other practice location 3

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address pleonberger61254@sih.direct-ci.com
Direct Messaging Address pleonberger61254@sih.direct-ci.com
Direct Messaging Address pleonberger61254@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200310002753 IL Practitioner - Internal MedicinePractitioner - Hospitalist 2163796566 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Internal Medicine Current Accepting new patients
Carle Health Medical Group Internal Medicine CurrentSince Feb 18, 2020 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Mar 1, 2023 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Feb 18, 2020 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Southern Illinois Medical Services, NFP Internal Medicine CurrentSince Jul 20, 2022 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Mar 1, 2023 Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352

201 S 14th St
Herrin, IL 62948
Phone (618) 942-2171

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

2 S Hospital Dr
Murphysboro, IL 62966
Phone (618) 684-3156

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: pleonbergerdo304532@carlehiedirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1400112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1063823763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163089",
            "telephone_number": "314-517-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S UNIVERSITY AVE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163089",
            "telephone_number": "314-517-8214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011462",
            "country_code": "US",
            "telephone_number": "618-549-0721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONBERGER",
        "first_name": "PATRICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-15",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036151501",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "69793-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pleonberger61254@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2 S Hospital Dr",
            "city": "Murphysboro",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629663333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pleonberger61254@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "201 S 14th St",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483631",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pleonberger61254@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 W Jackson St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.