Dmitry Leongardt, M.D.
Individual provider Active NPI Internal Medicine Physician · Chico, CA
NPI 1174549554 · NPPES record last updated Dec 18, 2018
Key facts
- NPI
- 1174549554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A78047 (CA)
- Practice address
- 1531 Esplanade
Chico, CA 95926-3310 - Phone
- (530) 332-5557
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Providence Medical Foundation
Practice addresses (Care Compare)
1000 Trancas St
Napa, CA 94558-2906
Phone (707) 252-4411
Hospital & facility affiliations
- Providence Queen of the Valley Medical Center
- Sonoma Valley Hospital
- Petaluma Valley Hospital
- Adventist Health St Helena
- Adventist Health Clearlake
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041203000723 | CA | Practitioner - Internal Medicine |
4082670849 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A78047 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| Inpatient Specialists of California, PC | Internal Medicine | Current |
Accepting new patients |
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Enloe Medical Center | Past | Accepting new patients | |
| Adventist Health Clearlake Hospital Inc. | Past | Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients |
Locations
1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850
1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901
400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111
1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210
10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 963-2002
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
1800 N California St
Stockton, CA 95204
Phone (209) 467-6400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A78047 | CA | Yes |
Addresses
Primary practice location
1531 Esplanade
Chico, CA 95926-3310
Mailing address
942 Appleridge CT
Fairfield, CA 94534-4074
Phone (707) 419-4530
Other practice location 1
300 Hospital Dr
Sutter Solano Hospital
Vallejo, CA 94589-2574
Phone (707) 554-4444
Other providers in Chico, CA
- Rose Nichole Lenhardt
- Mallory Lent
- Andrea Grace Leonard
- Michele Leone
- Rachel Leone
- Allysa Lepage
- Lerner Chiropractic
- James Robert Lerner
- Jeremy David Lerner
- Montana Leroux
All providers in Chico, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.