Individual provider Active NPI

Oscar Alejandro Leyva Camacho, MD

  • Aerospace Medicine Physician
  • Charleston AFB, SC
National Provider Identifier
1104524321
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Aerospace Medicine PhysicianTaxonomy code 2083A0100X
License
0101283103 Issued in VA
Practice address
204 W Hill Blvd
Charleston AFB, SC 29404-4704
Phone
(843) 963-6722
NPI assigned
Feb 16, 2023
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Aerospace Medicine Physician 2083A0100X 0101283103 VA Primary

Addresses

Primary practice location

204 W Hill Blvd
Charleston AFB, SC 29404-4704

Mailing address

204 W Hill Blvd
Charleston AFB, SC 29404-4704
Phone (843) 963-6722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101283103VAMDAerospace Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1104524321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON AFB",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON AFB",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYVA CAMACHO",
        "first_name": "OSCAR",
        "middle_name": "ALEJANDRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-16",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "VA",
            "license": "0101283103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston AFB, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.