Individual provider Active NPI

Jorge Martinez-Leyva, M.D.

  • Neurological Surgery Physician
  • Shreveport, LA
National Provider Identifier
1083726368
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
R4212 Issued in LA
Practice address
8001 Youree Dr
Suite 850
Shreveport, LA 71115-2302
Phone
(318) 424-2623
Fax
(318) 227-1357
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X R4212 LA Primary

Addresses

Primary practice location

8001 Youree Dr
Suite 850
Shreveport, LA 71115-2302

Mailing address

8001 Youree Dr
Ste 850
Shreveport, LA 71115-2327
Phone (318) 424-2623

Other identifiers 1

IdentifierTypeStateIssuer
1196789MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20031209000045 LA Practitioner - Emergency Medicine 9830095108 Practice locations: Shreveport, LA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4212LAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jorge Martinez-Leyva, MD Neurological Surgery PastSince Jun 17, 1976 Accepting new patients

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1083726368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "STE 850",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152327",
            "telephone_number": "318-424-2623",
            "fax_number": "318-227-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 YOUREE DR",
            "address_2": "SUITE 850",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711152302",
            "telephone_number": "318-424-2623",
            "fax_number": "318-227-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-LEYVA",
        "first_name": "JORGE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "R4212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1196789",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.