Active NPI
Ginger Lina Leon, D.O.
- Family Medicine Physician
- Montclair, CA
National Provider Identifier
1245234780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20A 8311
- Practice address
- 5404 Moreno St
Ste. N
Montclair, CA 91763-1667 - Phone
- (909) 949-4400
- Fax
- (909) 949-4441
- NPI assigned
- Jun 13, 2005
- Last updated
- Dec 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20A 8311 | CA | Primary |
Addresses
Primary practice location
5404 Moreno St
Ste. N
Montclair, CA 91763-1667
Mailing address
5404 Moreno St
Ste. N
Montclair, CA 91763-1667
Phone (909) 949-4400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FL767Y | Other | CA | MEDICARE PTAN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2001
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5404 Moreno St
Montclair, CA 91763-1665
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A 8311 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montclair Vida Health Clinic PC | Current | Accepting new patients | |
| Montclair Family Medical Center Inc | Past | Accepting new patients |
Locations
5404 Moreno St
Ste G
Montclair, CA 91763
Phone (909) 949-4400
5404 Moreno St
Ste N
Montclair, CA 91763
Phone (909) 949-4400
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- vidahealthclinic.gingerleon@136751.advancedmd-direct.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Priority One Hospice, Inc. | Hospice | Contracted Managing Employee | Jan 2, 2014 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Montclair, CA
- NPI 1720334626
Contracted Managing Employee
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.
-
- Health Service Clinic/Center
- Montclair, CA
- NPI 1699034827
-
- Family Medicine Physician
- Montclair, CA
- NPI 1588016364
-
dba Royal care medical center
- Legal Medicine
- Ontario, CA
- NPI 1619144227
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Chino, CA
- NPI 1760427439
-
- Community Based Hospice Care Agency
- Upland, CA
- NPI 1841425170
-
- Community Based Hospice Care Agency
- Montclair, CA
- NPI 1720334626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418601600000",
"number": "1245234780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5404 MORENO ST",
"address_2": "STE. N",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917631667",
"telephone_number": "909-949-4400",
"fax_number": "909-949-4441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5404 MORENO ST",
"address_2": "STE. N",
"city": "MONTCLAIR",
"state": "CA",
"postal_code": "917631667",
"telephone_number": "909-949-4400",
"fax_number": "909-949-4441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "GINGER",
"middle_name": "LINA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-06-13",
"last_updated": "2014-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "20A 8311",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "FL767Y",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.