Individual provider Active NPI

Derek Leaderer, M.D.

  • Vascular Surgery Physician
  • Celebration, FL
National Provider Identifier
1104351980
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME174788 Issued in FL
Practice address
410 Celebration PL Ste 402
Celebration, FL 34747-5436
Phone
(407) 303-4080
Fax
(407) 303-7255
NPI assigned
Apr 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME174788 FL Primary

Addresses

Primary practice location

410 Celebration PL Ste 402
Celebration, FL 34747-5436

Mailing address

410 Celebration PL Ste 402
Celebration, FL 34747-5436
Phone (407) 303-4080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250822001317 FL Practitioner - Vascular Surgery 9537432067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Tufts University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

410 Celebration PL
Suite 302
Celebration, FL 34747-5435
Phone (407) 303-3824

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME174788FLMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 8, 2025 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Sep 8, 2025 Accepting new patients

Locations

410 Celebration Pl
Ste 402
Kissimmee, FL 34747
Phone (407) 296-1871

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

Organizations & group practices 2

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 2

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1104351980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 402",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4080",
            "fax_number": "407-303-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL STE 402",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475436",
            "telephone_number": "407-303-4080",
            "fax_number": "407-303-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADERER",
        "first_name": "DEREK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME174788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.