NPIMap

Individual provider Active NPI

Dmitry Leongardt, M.D.

  • Internal Medicine Physician
  • Chico, CA
National Provider Identifier
1174549554
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A78047 Issued in CA
Practice address
1531 Esplanade
Chico, CA 95926-3310
Phone
(530) 332-5557
NPI assigned
Jul 15, 2006
Last updated
Dec 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A78047 CA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041203000723 CA Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists)Practitioner - Hospitalist 4082670849 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Hospitalist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1000 Trancas St
Napa, CA 94558-2906
Phone (707) 252-4411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78047CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Sep 28, 2020 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Sep 28, 2020 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Adventist Health Clearlake Hospital Inc. Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Enloe Medical Center Past Accepting new patients
Humboldt Medical Specialists, Inc Past Accepting new patients

Locations

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

1100 Trancas St
Ste 209
Napa, CA 94558
Phone (707) 251-1850

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

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1174549554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 APPLERIDGE CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945344074",
            "telephone_number": "707-419-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 ESPLANADE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263310",
            "telephone_number": "530-332-5557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hospital Dr",
            "address_2": "Sutter Solano Hospital",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945892574",
            "country_code": "US",
            "telephone_number": "707-554-4444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONGARDT",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.