Individual provider Active NPI

Leisa McDonnough-Genin, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1114257896
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
254776 Issued in NY
Practice address
4802 10TH Ave
Brooklyn, NY 11219-2916
Phone
(718) 283-6000
NPI assigned
Jan 3, 2010
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA09298400 NJ
Emergency Medicine Physician 207P00000X 254776 NY Primary

Addresses

Primary practice location

4802 10TH Ave
Brooklyn, NY 11219-2916

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916
Phone (718) 283-6000

Other names 1

  • Dr. Leisa McDonnough Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100610000305 NY Practitioner - Emergency Medicine 0547390072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York Downstate Medical Center, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Services of New York PCGroup PAC ID 3678678646, 43 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Sep 15, 2024 Accepting new patients

Locations

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

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 1

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": "1262476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1114257896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNOUGH-GENIN",
        "first_name": "LEISA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-03",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA09298400",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "254776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEISA",
            "last_name": "MCDONNOUGH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.