Individual provider Active NPI

Brett Dustin Leggett, MD

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1265524375
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD487565 Issued in PA
Practice address
160 E Erie Ave
Philadelphia, PA 19134-1011
Phone
(215) 427-4067
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0067479 CO
Hospitalist Physician 208M00000X 0067479 CO
Pediatrics Physician 208000000X MD487565 PA Primary

Addresses

Primary practice location

160 E Erie Ave
Philadelphia, PA 19134-1011

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Other practice location 2

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, PA2 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
I20211216001525 CO Practitioner - HospitalistPractitioner - Pediatric Medicine 1951585686 Reassigns benefits to 1 organization
I20250303000348 PA Practitioner - Pediatric Medicine 1951585686 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD487565PAMDPediatrics Physician
0067479COMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jan 1, 2022 Accepting new patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Feb 10, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jan 1, 2022 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Feb 10, 2025 Accepting new patients
STC Opco LLC Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Organizations & group practices 6

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1265524375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-4067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044597",
            "country_code": "US",
            "telephone_number": "303-436-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGGETT",
        "first_name": "BRETT",
        "middle_name": "DUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "0067479",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "0067479",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD487565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.