Individual provider Active NPI

Leandro Ariel Espinosa, MD

  • Diagnostic Radiology Physician
  • Grafton, WI
National Provider Identifier
1124144217
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
53913 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(414) 358-5437
Fax
(414) 358-5421
NPI assigned
Mar 21, 2007
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 53913 WI Primary

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

4025 N 92ND St
Amg Imaging
Wauwatosa, WI 53222-1613
Phone (414) 358-5437

Other identifiers 2

IdentifierTypeStateIssuer
100009041MedicaidWI
P00882934OtherWIRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address lespinosa8716@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20101108000647 WI Practitioner - Diagnostic Radiology 5890849558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Stanford University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1055 N Mayfair Rd
Wauwatosa, WI 53226-3436
Phone (414) 476-8450

1061 E Commerce Boulevard
Slinger, WI 53086-9326
Phone (262) 644-2900

1100 Gateway CT
West Bend, WI 53095-8539
Phone (262) 335-8600

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

1475 W Grand Ave
Port Washington, WI 53074-2074
Phone (262) 268-5100

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

200 E Layton Ave
Milwaukee, WI 53207-5908
Phone (414) 744-6589

205 Valley Ave
West Bend, WI 53095-5312
Phone (262) 338-1123

215 W Washington St
Grafton, WI 53024-1700
Phone (262) 375-3700

2424 S 90TH St
Suite 306
West Allis, WI 53227-2455
Phone (414) 328-8750

2801 W Kinnickinnic River Pkwy
Suite 345
Milwaukee, WI 53215-3669
Phone (414) 649-7900

2999 N Mayfair Rd
Suite 100
Wauwatosa, WI 53222-4306
Phone (414) 479-7000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

3055 Hubertus Rd
Hubertus, WI 53033-9316
Phone (262) 628-9000

325 E Silver Spring Dr
Whitefish Bay, WI 53217-5222
Phone (414) 247-4800

3289 N Mayfair Rd
Wauwatosa, WI 53222-3203
Phone (414) 771-7900

6425 W Mequon Rd
Mequon, WI 53092-1855
Phone (262) 242-0051

9120 W Loomis Rd
Suite 100
Franklin, WI 53132-9083
Phone (414) 858-1740

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-2000

975 Port Washington Rd
Grafton, WI 53024-9204
Phone (262) 329-8650

N112 W17975 Mequon Rd
Germantown, WI 53022-2425
Phone (262) 532-7600

W180N11070 River LN
Germantown, WI 53022-3109
Phone (262) 532-9700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Jan 4, 2016 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 1, 2010 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 4, 2016 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology CurrentSince Jan 4, 2016 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 1, 2010 Accepting new patients

Locations

112 N US Highway 141
Crivitz, WI 54114
Phone (715) 735-6621

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

5818 W Capitol Dr
Milwaukee, WI 53216
Phone (414) 447-8071

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

4025 N 92nd St
Wauwatosa, WI 53222
Phone (414) 358-5431

Interoperability endpoints

  • Direct secure messaging: lespinosa8716@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 7

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1124144217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N 92ND ST",
            "address_2": "AMG IMAGING",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221613",
            "telephone_number": "414-358-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "414-358-5437",
            "fax_number": "414-358-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "LEANDRO",
        "middle_name": "ARIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "53913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100009041",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00882934",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lespinosa8716@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "975 Port Washington Rd",
            "city": "Grafton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530249201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.