Organization Active NPI

Medical Physicians Group PLLC

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1114408648
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL PHYSICIANS GROUP PLLC
Practice address
290 NW Peacock Blvd # 880891
Port Saint Lucie, FL 34986-2205
Phone
(816) 398-8916
NPI assigned
Aug 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Authorized official

Name
Dr. Pat Leung, MD
Title
Ceo/Physician
Phone
(863) 874-0898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

290 NW Peacock Blvd # 880891
Port Saint Lucie, FL 34986-2205

Mailing address

PO Box 186
Unit 186
Macclenny, FL 32063
Phone (863) 874-0898

Other identifiers 1

IdentifierTypeStateIssuer
1124461124OtherNPI

National Provider Directory

National Provider Directory
Tax ID family
Medical Physicians Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

290 NW Peacock Blvd
#880891
Port St Lucie, FL 34986
Phone (816) 398-8916

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1114408648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "address_2": "UNIT 186",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "32063",
            "telephone_number": "863-874-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 NW PEACOCK BLVD # 880891",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862205",
            "telephone_number": "816-398-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PHYSICIANS GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "LEUNG",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "CEO/PHYSICIAN",
        "authorized_official_telephone_number": "863-874-0898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124461124",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; 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.