Individual provider Active NPI

Leonardo Mastache, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Naples, FL
National Provider Identifier
1104699297
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11029403 Issued in FL
Practice address
4349 18TH PL SW
Naples, FL 34116-5917
Phone
(239) 692-2630
NPI assigned
Nov 1, 2023
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11029403 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11029403 FL Primary

Addresses

Primary practice location

4349 18TH PL SW
Naples, FL 34116-5917

Mailing address

4349 18TH PL SW
Naples, FL 34116-5917
Phone (239) 692-2630

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241028003270 FL Practitioner - Nurse Practitioner 2668905746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Collier Health Services, IncGroup PAC ID 4183521925, 29 clinicians

Practice addresses (Care Compare)

1454 Madison Ave W
Immokalee, FL 34142-2200
Phone (239) 658-3064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11029403FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Collier Health Services, Inc CurrentSince Nov 5, 2024 Accepting new patients
Collier Health Services Inc CurrentSince Nov 5, 2024 Accepting new patients
Gda Blalance Medical LLC Family CurrentSince Nov 12, 2023 Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients

Locations

125 Boston Ave
Immokalee, FL 34142
Phone (239) 657-5800

1454 Madison Ave W
Immokalee, FL 34142
Phone (239) 658-3064

12655 Collier Blvd
Naples, FL 34116
Phone (239) 571-9015

1845 Veterans Park Dr
Naples, FL 34109
Phone (239) 571-9015

2355 Stanford Ct
Ste 701
Naples, FL 34112

Interoperability endpoints

  • Direct secure messaging: leonardo.mastache.1@10865.direct.athenahealth.com

Organizations & group practices 35

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.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1104699297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4349 18TH PL SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165917",
            "telephone_number": "239-692-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4349 18TH PL SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165917",
            "telephone_number": "239-692-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTACHE",
        "first_name": "LEONARDO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-01",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11029403",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11029403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.