Individual provider Active NPI

Brittany Leader

  • Facial Plastic Surgery Physician
  • Palo Alto, CA
National Provider Identifier
1164817359
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
A168535 Issued in CA
Practice address
101 Addison Ave
Palo Alto, CA 94301-2401
Phone
(650) 433-8621
Fax
(650) 434-0061
NPI assigned
Apr 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 57.026181 OH
Student in an Organized Health Care Education/Training Program 390200000X
Facial Plastic Surgery Physician 207YS0123X A168535 CA Primary

Addresses

Primary practice location

101 Addison Ave
Palo Alto, CA 94301-2401

Mailing address

101 Addison Ave
Palo Alto, CA 94301-2401
Phone (650) 433-8621

Other practice location 1

2400 Samaritan Dr Ste 206
San Jose, CA 95124-3910
Phone (408) 369-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150716001843 OH Order and Referring Only - OtolaryngologyPractitioner - Otolaryngology 5597078766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57.026181OHMDOtolaryngology Physician
A168535CAMDFacial Plastic Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1164817359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 ADDISON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012401",
            "telephone_number": "650-433-8621",
            "fax_number": "650-434-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ADDISON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012401",
            "telephone_number": "650-433-8621",
            "fax_number": "650-434-0061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Samaritan Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951243910",
            "country_code": "US",
            "telephone_number": "408-369-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEADER",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "57.026181",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "A168535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.