Individual provider Active NPI

Philip Leo, MD

  • Family Medicine Physician
  • Staten Island, NY
National Provider Identifier
1184619371
Registry record updated Dec 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
146569 Issued in NY
Practice address
11 Ralph PL
Suite 213
Staten Island, NY 10304-4419
Phone
(718) 556-9400
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 146569 NY Primary

Addresses

Primary practice location

11 Ralph PL
Suite 213
Staten Island, NY 10304-4419

Mailing address

11 Ralph PL
Suite 213
Staten Island, NY 10304-4419
Phone (718) 556-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040804001754 NY Practitioner - Family Practice 5294706933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
George Washington University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9292

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
146569NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital PC Family Medicine CurrentSince Aug 1, 2016 Accepting new patients
Physicians of University Hospital, PC Current Accepting new patients
Physicians of University Hospital, PC CurrentSince Aug 1, 2016 Accepting new patients

Locations

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

11 Ralph Pl
Staten Island, NY 10304
Phone (718) 273-5666

11 Ralph Pl
Ste 213
Staten Island, NY 10304
Phone (718) 556-9400

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: pleo65471@northwell.direct-ci.com

Organizations & group practices 3

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 4

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356220800000",
    "number": "1184619371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 213",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044419",
            "telephone_number": "718-556-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 RALPH PL",
            "address_2": "SUITE 213",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103044419",
            "telephone_number": "718-556-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2012-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "146569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.