Individual provider Active NPI

Nicholas Raymond Leonardi, D.O.

  • Plastic and Reconstructive Surgery Physician
  • Germantown, TN
National Provider Identifier
1104072651
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
2861 Issued in TN
Practice address
7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone
(901) 683-0055
NPI assigned
Aug 15, 2008
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 2861 TN Primary

Addresses

Primary practice location

7945 Wolf River Blvd
Germantown, TN 38138-1762

Mailing address

7714 Poplar Ave Ste 200
Germantown, TN 38138-3941
Phone (190) 168-3005

Other identifiers 2

IdentifierTypeStateIssuer
02738884MedicaidMS
Q020806MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@wcc.oncoemrdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150624001981 TN Practitioner - Plastic and Reconstructive Surgery 6103137658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Midwestern University, Chicago College of Osteopathic Med, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The West Clinic P.C.Group PAC ID 2668360579, 115 clinicians

Practice addresses (Care Compare)

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as subgroup
Quality
83.22
Promoting interoperability
100
Improvement activities
40
Cost
77.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy51
Melanoma (skin cancer) excision43
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The West Clinic P.C. CurrentSince Aug 1, 2022 Accepting new patients

Locations

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

7714 Poplar Ave
Ste 200
Memphis, TN 38138
Phone (901) 322-9080

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

80 Humphreys Center Dr
Ste 100
Memphis, TN 38120
Phone (901) 761-9030

Interoperability endpoints

  • Direct secure messaging: admin@wcc.oncoemrdirect.com
  • Direct secure messaging: nleonardi31382@mlh.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1104072651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 POPLAR AVE STE 200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383941",
            "telephone_number": "190-168-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDI",
        "first_name": "NICHOLAS",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TN",
            "license": "2861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02738884",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q020806",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@wcc.oncoemrdirect.com",
            "affiliation": "N",
            "address_1": "7945 Wolf River Blvd",
            "city": "Germantown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381381762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.