Individual provider Active NPI

Nilsa Leiva, M.D.

  • Internal Medicine Physician
  • Bradenton, FL
National Provider Identifier
1114924339
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME82566 Issued in FL
Practice address
3904 Cortez Rd W
Bradenton, FL 34210-3111
Phone
(941) 345-1943
Fax
(941) 345-1944
NPI assigned
Jul 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME82566 FL
Internal Medicine Physician 207R00000X ME82566 FL Primary

Addresses

Primary practice location

3904 Cortez Rd W
Bradenton, FL 34210-3111

Mailing address

3904 Cortez Rd W
Bradenton, FL 34210-3111
Phone (941) 345-1943

Other identifiers 2

IdentifierTypeStateIssuer
13634OtherFLFL BCBS
280623100MedicaidFL

Other names 1

  • Nilsa Leiva Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000240 FL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2567505456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optimum Point of Care Physicians Group LLCGroup PAC ID 0941560759, 2 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

3904 Cortez Rd W
Bradenton, FL 34210-3203
Phone 9413451943129

7374 San Casa Dr
Englewood, FL 34224-8842
Phone (941) 417-5064

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Point of Care Physicians Group, LLC Internal Medicine CurrentSince Oct 5, 2017 Accepting new patients
Healthcare America Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

3904 Cortez Rd W
Bradenton, FL 34210
Phone (941) 345-1943

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJFABD
  • FHIR API: https://fhir4.healow.com/fhir/r4/CJFABD/Endpoint/CJFABD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1114924339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103111",
            "telephone_number": "941-345-1943",
            "fax_number": "941-345-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3904 CORTEZ RD W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103111",
            "telephone_number": "941-345-1943",
            "fax_number": "941-345-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIVA",
        "first_name": "NILSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME82566",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME82566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "13634",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280623100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NILSA",
            "last_name": "LEIVA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.