Individual provider Active NPI

Leilani Melissa Magdaleno, DO

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1205416161
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U6757 Issued in TX
Practice address
425 University Blvd Ste 500
Round Rock, TX 78665-1047
Phone
(512) 509-0200
NPI assigned
Apr 13, 2021
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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 U6757 TX Primary

Addresses

Primary practice location

425 University Blvd Ste 500
Round Rock, TX 78665-1047

Mailing address

PO Box 5730
Belfast, ME 04915-5700
Phone (888) 402-7256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240516000903 TX Practitioner - Family Practice 2466861059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

7719 S Ih
35 Suite 212
San Antonio, TX 78224-1469
Phone (830) 320-4955

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U6757TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc Family Medicine CurrentSince May 1, 2024 Accepting new patients
BHS Physicians Network, Inc CurrentSince May 1, 2024 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

7719 S Ih 35
Ste 212
San Antonio, TX 78224
Phone (210) 928-2273

Interoperability endpoints

  • Direct secure messaging: leilani.magdaleno.1@1438.direct.athenahealth.com
  • Direct secure messaging: lmagdaleno828111@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1205416161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5730",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155700",
            "telephone_number": "888-402-7256",
            "fax_number": "888-902-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD STE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651047",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGDALENO",
        "first_name": "LEILANI",
        "middle_name": "MELISSA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U6757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.