Individual provider Active NPI

Mario Mendes Leitao Jr., M.D.

  • Gynecologic Oncology Physician
  • New York, NY
National Provider Identifier
1225068372
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
208249 Issued in NY
Practice address
1275 York Ave # H1314
New York, NY 10065-6007
Phone
(212) 639-3987
Fax
(212) 717-3709
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 25MA07727200 NJ
Gynecologic Oncology Physician 207VX0201X 208249 NY Primary

Addresses

Primary practice location

1275 York Ave # H1314
New York, NY 10065-6007

Mailing address

1275 York Ave # H1314
New York, NY 10065-6007
Phone (646) 620-2438

Other identifiers 1

IdentifierTypeStateIssuer
0043800MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041206000977 NJ Practitioner - Gynecological Oncology 1951367598 Reassigns benefits to 1 organization
I20070515000593 NY Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 1951367598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mskcc Surgery GroupGroup PAC ID 0345131405, 365 clinicians

Practice addresses (Care Compare)

1133 York Ave
New York, NY 10065-8307
Phone (646) 888-7100

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000

160 E 53Rd St
New York, NY 10022-5243
Phone (212) 610-0496

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
81.57 of 100Reported as group
Quality
72.31
Improvement activities
40
Cost
76.55

Merit-based Incentive Payment System (MIPS)

Final score
85.97 of 100Reported as group
Quality
82.74
Improvement activities
40
Cost
79.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of the uterus28

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208249NYMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Surgery Group CurrentSince Mar 19, 2007 Accepting new patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey CurrentSince Mar 19, 2007 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
#H1314
New York, NY 10065
Phone (212) 639-3987

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

353 E 68th St
New York, NY 10065
Phone (646) 422-4300

Networks

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

Interoperability endpoints

  • Direct secure messaging: mleitao39084@mskcc.direct-ci.com

Organizations & group practices 2

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 5

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1225068372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE # H1314",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "646-620-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE # H1314",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-3987",
            "fax_number": "212-717-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITAO",
        "first_name": "MARIO",
        "middle_name": "MENDES",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NJ",
            "license": "25MA07727200",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NY",
            "license": "208249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.