NPIMap

Individual provider Active NPI

Christian Leonardi, D.O.

  • Internal Medicine Physician
  • New Milford, CT
National Provider Identifier
1134112824
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
45397 Issued in CT
Practice address
11 Old Park Lane
New Milford, CT 06776
Phone
(860) 355-1149
Fax
(860) 355-5957
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 45397 CT Primary
Internal Medicine Physician 207R00000X 036111922 IL

Addresses

Primary practice location

11 Old Park Lane
New Milford, CT 06776

Mailing address

11 Old Park Lane
New Milford, CT 06776
Phone (860) 355-1149

Other identifiers 2

IdentifierTypeStateIssuer
036111922MedicaidIL
008016289MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071004000313 CT Practitioner - Internal Medicine 9335100528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Milford Medical Group, LLCGroup PAC ID 3678469384, 10 clinicians

Practice addresses (Care Compare)

11 Old Park Lane
New Milford, CT 06776-2507

11 Old Park Lane Rd
New Milford, CT 06776-2507
Phone (860) 355-1149

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Milford Medical Group, LLC Internal Medicine CurrentSince Aug 20, 2007 Accepting new patients
Granite City Physicians Corp Past Accepting new patients

Locations

11 Old Park Lane Rd
New Milford, CT 06776
Phone (860) 355-1149

Interoperability endpoints

  • Direct secure messaging: christian.leonardi.p1@direct.nmmg.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 8

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1134112824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 OLD PARK LANE",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "06776",
            "telephone_number": "860-355-1149",
            "fax_number": "860-355-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 OLD PARK LANE",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "06776",
            "telephone_number": "860-355-1149",
            "fax_number": "860-355-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDI",
        "first_name": "CHRISTIAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "45397",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036111922",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111922",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008016289",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.