Individual provider Active NPI

Sergio A Leon, M.D.

  • Rheumatology Physician
  • Beaumont, TX
National Provider Identifier
1083814057
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
S4806 Issued in TX
Practice address
3030 North St Ste 450
Beaumont, TX 77702-1434
Phone
(409) 832-9600
Fax
(409) 832-9310
NPI assigned
Jul 19, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X ME 104595 FL
Rheumatology Physician 207RR0500X D0071211 MD
Rheumatology Physician 207RR0500X 0101249525 VA
Rheumatology Physician 207RR0500X S4806 TX Primary

Addresses

Primary practice location

3030 North St Ste 450
Beaumont, TX 77702-1434

Mailing address

2900 Saint Michael Dr Ste 401
Texarkana, TX 75503-5211
Phone (903) 614-5367

Other practice location 1

3027 Javier Rd
Suite 2
Fairfax, VA 22031-4652
Phone (703) 573-2220

Other identifiers 4

IdentifierTypeStateIssuer
939915OtherTXMEDICARE
P00815670OtherFLRAILROAD MEDICARE
1K1864OtherTXMEDICARE
P02601534OtherTXMCRR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200302000294 TX Practitioner - RheumatologyPractitioner - Internal Medicine 3274687454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

3030 N St
450 Christus St. Elizabeth Med GRP Setx Rhe
Beaumont, TX 77702-1434
Phone (409) 832-9600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 104595FLMDRheumatology Physician
0101249525VAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Wilkinson Physician Network CurrentSince Mar 16, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince Mar 16, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Dec 1, 2020 Accepting new patients
Christus Trinity Clinic Texas Rheumatology CurrentSince Dec 1, 2020 Accepting new patients
Trinity Clinic Past Accepting new patients

Locations

3030 North St
Ste 450
Beaumont, TX 77702
Phone (409) 832-9600

3030 North St
Ste 420
Beaumont, TX 77702
Phone (409) 835-2900

2246 Nall St
Port Neches, TX 77651
Phone (409) 344-4010

2900 Saint Michael Dr
Ste 401
Texarkana, TX 75503
Phone (903) 614-5353

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
  • Direct secure messaging: sleon239680@christushealth.direct-ci.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEBBD

Organizations & group practices 5

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 3

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": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1083814057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT MICHAEL DR STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035211",
            "telephone_number": "903-614-5367",
            "fax_number": "903-614-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NORTH ST STE 450",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021434",
            "telephone_number": "409-832-9600",
            "fax_number": "409-832-9310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3027 Javier Rd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314652",
            "country_code": "US",
            "telephone_number": "703-573-2220",
            "fax_number": "703-573-7767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON",
        "first_name": "SERGIO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME 104595",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MD",
            "license": "D0071211",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "VA",
            "license": "0101249525",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "S4806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "939915",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00815670",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1K1864",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02601534",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

Verify at the official NPI Registry.