Jesse Mata De Leon, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

A32517 Issued in CA

Practice address

16660 Paramount Blvd
Suite 211
Paramount, CA 90723-5433

Phone

(562) 633-5438

Fax

(562) 633-1685

NPI assigned

Apr 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

University College of Medicine, 1969

Medicare assignment

May accept Medicare assignment

Group practices

J and L de Leon Medical CorporationGroup PAC ID 3870780786, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• J & L de Leon Medical Corporation

  • Pediatrics Physician
  • Paramount, CA
  • NPI 1760407621

  Ophthalmology

  Medicare reassignment Care Compare group NPD Authorized official
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225251606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16660 PARAMOUNT BLVD",
            "address_2": "SUITE 211",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235433",
            "telephone_number": "562-633-5438",
            "fax_number": "562-633-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16660 PARAMOUNT BLVD",
            "address_2": "SUITE 211",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235433",
            "telephone_number": "562-633-5438",
            "fax_number": "562-633-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "JESSE",
        "middle_name": "MATA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A32517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A325170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rezarta Davis, PH.D.
• Ervin De Guzman, FNP
• Joshua Miguel Vergel de Dios De Joya, RD
• Lorena De la Cruz
• Jose Luis De la Rosa, M.D.
• Liberation Bongato De Leon, M.D.
• Jayceelyn Guzman Delacruz
• Sonam Desai
• Diem Cao DDS Inc (Kaizen Dental)
• Sydney Dixon

• Ophthalmology Physician in Paramount, CA
• Providers in Paramount, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.