Individual provider Active NPI

Vladimir Leibovsky, D.O.

  • Obstetrics & Gynecology Physician
  • Stockton, CA
National Provider Identifier
1184898397
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A13003 Issued in CA
Practice address
2545 W Hammer LN
Stockton, CA 95209-2839
Phone
(209) 957-7050
NPI assigned
Apr 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A13003 CA Primary

Addresses

Primary practice location

2545 W Hammer LN
Stockton, CA 95209-2839

Mailing address

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 521-6097

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140331000054 CA Practitioner - Obstetrics/Gynecology 3274764535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

337 Eldorado St
Suite B4
Monterey, CA 93940
Phone (831) 373-2486

Hospital & facility affiliations

  • Community Hospital of the Monterey Peninsula Hospital, Monterey, CA, CCN 050145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13003CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHP of California Medical Group Inc Obstetrics & Gynecology CurrentSince May 1, 2016 Accepting new patients
Laima OBGYN Inc Obstetrics & Gynecology CurrentSince Jul 19, 2017 Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
Franciscan Health System Past Accepting new patients

Locations

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

337 El Dorado St
Ste B4
Monterey, CA 93940
Phone (831) 373-2486

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBGGAD/Endpoint/JBGGAD

Organizations & group practices 4

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 2

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": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1184898397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COFFEE RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554201",
            "telephone_number": "209-521-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092839",
            "telephone_number": "209-957-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOVSKY",
        "first_name": "VLADIMIR",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-17",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A13003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.