Active NPI
Keith A. Leibowitz, MD
- Gastroenterology Physician
- Modesto, CA
National Provider Identifier
1083689335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G129017
- Practice address
- 700 17TH St Ste 102
Modesto, CA 95354-1248 - Phone
- (209) 522-6100
- Fax
- (209) 522-6110
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 0101239026 | VA | |
| Gastroenterology Physician | 207RG0100X | G129017 | CA | Primary |
Addresses
Primary practice location
700 17TH St Ste 102
Modesto, CA 95354-1248
Mailing address
4120 Dale Rd.
Suite J8-240
Modesto, CA 95356
Phone (209) 522-6100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 192063 | Other | VA | ANTHEM |
| P00313962 | Other | RR/MEDICARE | |
| 010251338 | Medicaid | VA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | laptop | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- New York Medical College, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Modesto, CA 95354
Phone (757) 645-7079
Hospital & facility affiliations
- Doctors Medical Center
- Emanuel Medical Center
- Adventist Health Sonora
- John C Fremont Healthcare District
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 43 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 136 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G129017 | CA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Valley Gastroenterology Associates, Inc | Gastroenterology | Current | Accepting new patients |
| Keith Leibowitz M.D. a Professional Corporation | Gastroenterology | Current | Accepting new patients |
| Modesto Kidney Medical Group | Current | Accepting new patients |
Locations
700 17th St
Ste 102
Modesto, CA 95354
Phone (209) 488-3728
4120 Dale Rd
#J8240
Modesto, CA 95356
3430 Tully Rd
Ste 20
Modesto, CA 95350
981 E Tuolumne Rd
Ste 108
Turlock, CA 95382
Phone (209) 522-6100
981 E Tuolumne Rd
Ste 106
Turlock, CA 95382
Phone (209) 777-3500
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
-
- Gastroenterology Physician
- Modesto, CA
- NPI 1033989652
-
- Gastroenterology Physician
- Turlock, CA
- NPI 1659531317
-
- Nephrology Physician
- Modesto, CA
- NPI 1306848569
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1184654923
-
- General Acute Care Hospital
- Turlock, CA
- NPI 1396087672
-
- Critical Access Hospital
- Mariposa, CA
- NPI 1184662652
-
- General Acute Care Hospital
- Sonora, CA
- NPI 1780673376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653955200000",
"number": "1083689335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4120 DALE RD.",
"address_2": "SUITE J8-240",
"city": "MODESTO",
"state": "CA",
"postal_code": "95356",
"telephone_number": "209-522-6100",
"fax_number": "209-522-6110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 17TH ST STE 102",
"city": "MODESTO",
"state": "CA",
"postal_code": "953541248",
"telephone_number": "209-522-6100",
"fax_number": "209-522-6110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIBOWITZ",
"first_name": "KEITH",
"middle_name": "A.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2022-05-31",
"certification_date": "2022-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "VA",
"license": "0101239026",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G129017",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "192063",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR/MEDICARE",
"identifier": "P00313962",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010251338",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "laptop",
"affiliation": "N",
"endpointDescription": "laptop",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "700 17th St Ste 102",
"city": "Modesto",
"state": "CA",
"country_code": "US",
"postal_code": "953541248",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.