Individual provider Active NPI

Shelby C. Leuin, MD

  • Pediatric Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1124230909
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
A112930 Issued in CA
Practice address
3030 Childrens Way
Ste 402
San Diego, CA 92123-4232
Phone
(858) 309-7701
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A112930 CA
Pediatric Otolaryngology Physician 207YP0228X A112930 CA Primary

Addresses

Primary practice location

3030 Childrens Way
Ste 402
San Diego, CA 92123-4232

Mailing address

3860 Calle Fortunada
Ste #210
San Diego, CA 92123-4802
Phone (858) 309-6303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110601000773 CA Practitioner - Otolaryngology 6709073760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Un of California, Irvine, College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rady Children'S Hospital San DiegoGroup PAC ID 3971677493, 164 clinicians

Practice addresses (Care Compare)

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3030 Childrens Way
San Diego, CA 92123-4232
Phone (858) 576-1700

477 N El Camino Real
BLDG D
Encinitas, CA 92024-1328
Phone (619) 713-5375

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A112930CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego CurrentSince Apr 13, 2011 Accepting new patients
Rady Children'S Hospital San Diego CurrentSince Apr 13, 2011 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients
Children'S Hospital Colorado Past Accepting new patients

Locations

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

3605 Vista Way
Ste 172
Oceanside, CA 92056
Phone (760) 547-1000

3030 Childrens Way
Fl 1
San Diego, CA 92123
Phone (858) 966-8800

3020 Childrens Way
#5024
San Diego, CA 92123
Phone (858) 966-8030

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3030 Childrens Way
Ste 402
San Diego, CA 92123
Phone (858) 309-7701

Interoperability endpoints

  • Direct secure messaging: sleuin80979@radychildrens.direct-ci.com

Organizations & group practices 4

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1124230909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 CALLE FORTUNADA",
            "address_2": "STE #210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234802",
            "telephone_number": "858-309-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 CHILDRENS WAY",
            "address_2": "STE 402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234232",
            "telephone_number": "858-309-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUIN",
        "first_name": "SHELBY",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A112930",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "CA",
            "license": "A112930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.