NPIMap

Individual provider Active NPI

Margo Patricia Deleaver, M.D.

  • Pediatrics Physician
  • Culver City, CA
National Provider Identifier
1114061421
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C38896 Issued in CA
Practice address
3831 Hughes Ave Ste 601
Culver City, CA 90232-6844
Phone
(310) 838-4048
Fax
(310) 838-0491
NPI assigned
Feb 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C38896 CA Primary

Addresses

Primary practice location

3831 Hughes Ave Ste 601
Culver City, CA 90232-6844

Mailing address

3831 Hughes Ave Ste 601
Culver City, CA 90232-6844
Phone (310) 838-4048

Other identifiers 1

IdentifierTypeStateIssuer
00C388960MedicaidCA

Other names 1

  • Margo Patricia Deleaver-Russell Other name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C38896CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Healthcare System, Inc Past Accepting new patients
Complete Care Community Health Center, Inc Past Accepting new patients
Complete Care Community Health Center, Inc Past Accepting new patients
Complete Care Community Health Center, Inc PastSince Nov 17, 2019 Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: margo.deleavermd.p1@direct.ccchcenter.nextgenshare.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114061421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 601",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326844",
            "telephone_number": "310-838-4048",
            "fax_number": "310-838-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 HUGHES AVE STE 601",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902326844",
            "telephone_number": "310-838-4048",
            "fax_number": "310-838-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEAVER",
        "first_name": "MARGO",
        "middle_name": "PATRICIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C38896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C388960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGO",
            "last_name": "DELEAVER-RUSSELL",
            "middle_name": "PATRICIA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.