Individual provider Active NPI

Maria Lilian Leon, M.D

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1245579648
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q4175 Issued in TX
Practice address
5315 Ross Ave
Dallas, TX 75206-7418
Phone
(214) 826-2151
Fax
(214) 826-2196
NPI assigned
Feb 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q4175 TX Primary

Addresses

Primary practice location

5315 Ross Ave
Dallas, TX 75206-7418

Mailing address

3230 Interstate 30 Ste 100
Mesquite, TX 75150-2662
Phone (972) 682-1791

Other identifiers 1

IdentifierTypeStateIssuer
010562155MedicaidTX

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
I20201208001153 TX Practitioner - Pediatric Medicine 8921410499 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Current Accepting new patients
Dallas County Hospital District Pediatrics CurrentSince Apr 28, 2021 Accepting new patients
Dallas County Hospital District CurrentSince Apr 28, 2021 Accepting new patients
Ronald N Skufca DO PA CurrentSince Oct 19, 2020 Accepting new patients

Locations

5315 Ross Ave
Dallas, TX 75206
Phone (214) 253-2264

601 Clara Barton Blvd
Fl 2
Garland, TX 75042
Phone (214) 266-0651

601 Clara Barton Blvd
Garland, TX 75042
Phone (972) 272-5935

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1245579648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 INTERSTATE 30 STE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502662",
            "telephone_number": "972-682-1791",
            "fax_number": "972-698-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ROSS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752067418",
            "telephone_number": "214-826-2151",
            "fax_number": "214-826-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "MARIA",
        "middle_name": "LILIAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q4175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010562155",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.