Individual provider Active NPI

Patrick Leung, MD

  • Family Medicine Physician
  • Port Saint Lucie, FL
National Provider Identifier
1124461124
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME137161 Issued in FL
Practice address
290 NW Peacock Blvd #880891
Port Saint Lucie, FL 34986
Phone
(816) 398-8916
NPI assigned
Apr 10, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME137161 FL Primary

Addresses

Primary practice location

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

Mailing address

1400 S Coulter St Ste 5100
Suite 5100
Amarillo, TX 79106-1786
Phone (806) 414-9559

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
I20190227000049 FL Practitioner - General PracticePractitioner - Family Practice 6204124449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
University of Hawaii John a. Burns School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11555 Central Pkwy
Suite 903
Jacksonville, FL 32224-2701
Phone (863) 874-0898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME137161FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare at Twin Lakes LLC Multi-Specialty CurrentSince May 1, 2019 Accepting new patients
Medical Physicians Group PLLC Multi-Specialty CurrentSince Aug 22, 2018 Accepting new patients
Medical Physicians Group PLLC Multi-Specialty Current Accepting new patients

Locations

1890 Lpga Blvd
Ste 130
Daytona Beach, FL 32117
Phone (386) 274-2212

11555 Central Pkwy
Ste 903
Jacksonville, FL 32224
Phone (318) 996-8168

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

Organizations & group practices 3

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": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1124461124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST STE 5100",
            "address_2": "SUITE 5100",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9559",
            "fax_number": "806-351-3765"
        },
        {
            "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": "34986",
            "telephone_number": "816-398-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME137161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.