Individual provider Active NPI

Eric Edward Leonheart, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tacoma, WA
National Provider Identifier
1124085709
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO-00000778 Issued in WA
Practice address
9040 Jackson Avenue Madigan Army Medical Center
Tacoma, WA 98431-5820
Phone
(253) 968-1110
NPI assigned
Apr 27, 2006
Last updated
Apr 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO-00000778 WA Primary

Addresses

Primary practice location

9040 Jackson Avenue Madigan Army Medical Center
Tacoma, WA 98431-5820

Mailing address

121 SW 299TH PL
Federal Way, WA 98023-3572
Phone (425) 233-4597

Other practice location 1

10555 SE Carr Rd
Renton, WA 98055-5820
Phone (425) 203-7290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050802001129 WA Practitioner - Podiatry 6507838653 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO-00000778WAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton CurrentSince Jan 1, 2011 Accepting new patients
Temple University of the Commonwealth System of Higher Education Foot & Ankle Surgery Past Accepting new patients
Dpmleonheartprwa LLC Foot & Ankle Surgery Past Accepting new patients
Dpmsaltonprwa LLC Foot & Ankle Surgery Past Accepting new patients
Temple University of the Commonwealth System of Higher Education Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

3600 Lind Ave SW
Ste 100
Renton, WA 98057

Organizations & group practices 5

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1124085709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SW 299TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980233572",
            "telephone_number": "425-233-4597",
            "fax_number": "425-656-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984315820",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10555 SE Carr Rd",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555820",
            "country_code": "US",
            "telephone_number": "425-203-7290",
            "fax_number": "425-656-5422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONHEART",
        "first_name": "ERIC",
        "middle_name": "EDWARD",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO-00000778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.