Individual provider Active NPI

Brooke K Leon, N.P

  • Family Nurse Practitioner
  • San Mateo, CA
National Provider Identifier
1154561009
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
525190 Issued in CA
Practice address
290 Baldwin Ave
San Mateo, CA 94401-3915
Phone
(650) 343-4597
Fax
(650) 343-3402
NPI assigned
Mar 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 525190 CA Primary

Addresses

Primary practice location

290 Baldwin Ave
San Mateo, CA 94401-3915

Mailing address

290 Baldwin Ave
San Mateo, CA 94401-3915
Phone (650) 343-4597

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027001025 CA Practitioner - Nurse Practitioner 5395939979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Francisco School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy and Asthma Clinic IncorporatedGroup PAC ID 7810089075, 6 clinicians

Practice addresses (Care Compare)

290 Baldwin Ave
San Mateo, CA 94401-3915
Phone (650) 343-4597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
525190CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy and Asthma Clinic Incorporated CurrentSince Aug 1, 2010 Accepting new patients

Locations

290 Baldwin Ave
San Mateo, CA 94401
Phone (650) 343-4597

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1154561009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BALDWIN AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013915",
            "telephone_number": "650-343-4597",
            "fax_number": "650-343-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BALDWIN AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013915",
            "telephone_number": "650-343-4597",
            "fax_number": "650-343-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "BROOKE",
        "middle_name": "K",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "525190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.