Individual provider Active NPI

Luis Diego Leon, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Southington, CT
National Provider Identifier
1235361759
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
049613 Issued in CT
Practice address
1115 West St
Southington, CT 06489-6025
Phone
(860) 679-2766
NPI assigned
Aug 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 049613 CT
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 049613 CT Primary

Addresses

Primary practice location

1115 West St
Southington, CT 06489-6025

Mailing address

Uconn Medical Group
263 Farmington Avenue
Farmington, CT 06030-0001
Phone (860) 679-8400

Other practice location 1

80 Phoenix Ave
suite 201
Waterbury, CT 06702-1418
Phone (203) 756-8021

Other identifiers 1

IdentifierTypeStateIssuer
008036398MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lleon10853@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20110928000235 CT Practitioner - Internal MedicinePractitioner - Geriatric Medicine 9133390925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

Hospital & facility affiliations

  • Hartford Healthcare at Home Home health agency, East Hartford, CT, CCN 077041
  • Elara Caring Home health agency, Rocky Hill, CT, CCN 077163
  • Nurses at Home Inc Home health agency, Avon, CT, CCN 077273
  • John Dempsey Hospital of the University of Connect Hospital, Farmington, CT, CCN 070036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049613CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Connecticut Health Center CurrentSince Oct 13, 2017 Accepting new patients
University of Connecticut Health Center Internal Medicine CurrentSince Oct 13, 2017 Accepting new patients
University of Connecticut Health Center Past Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

1115 West St
Ste C
Southington, CT 06489

1115 West St
Southington, CT 06489
Phone (860) 276-6000

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 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": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1235361759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCONN MEDICAL GROUP",
            "address_2": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-8400",
            "fax_number": "860-679-8188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 WEST ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064896025",
            "telephone_number": "860-679-2766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Phoenix Ave",
            "address_2": "suite 201",
            "address_purpose": "LOCATION",
            "city": "Waterbury",
            "state": "CT",
            "postal_code": "067021418",
            "country_code": "US",
            "telephone_number": "203-756-8021",
            "fax_number": "203-596-9038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON",
        "first_name": "LUIS",
        "middle_name": "DIEGO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-17",
        "last_updated": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "049613",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "049613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008036398",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lleon10853@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

Verify at the official NPI Registry.