Individual provider Active NPI

Leslie Burgess, NP

  • Family Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1265893317
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95003707 Issued in CA
Practice address
8110 Mango Avenue
Fontana, CA 92335
Phone
(909) 427-1303
Fax
(909) 357-1581
NPI assigned
Mar 17, 2016
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95003707 CA Primary

Addresses

Primary practice location

8110 Mango Avenue
Fontana, CA 92335

Mailing address

8110 Mango Avenue
Fontana, CA 92335
Phone (909) 427-1303

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160919000974 CA Practitioner - Nurse Practitioner 0345537429 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exer Medical CorporationGroup PAC ID 9032359534, 336 clinicians

Practice addresses (Care Compare)

245 Terracina Blvd
Suite 102
Redlands, CA 92373-4865
Phone (909) 406-2671

7000 Boulder Ave
Suite 103
Highland, CA 92346-3348
Phone (515) 441-6271

839 Highland Springs Ave
Suite 101
Beaumont, CA 92223-5767
Phone (951) 521-1580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95003707CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Current Accepting new patients
Pinnacle Medical Group, Inc CurrentSince Jul 31, 2016 Accepting new patients
Cep America - California CurrentSince Jan 1, 2017 Accepting new patients
Pinnacle Medical Group, Inc CurrentSince Jul 31, 2016 Accepting new patients
Cep America-California CurrentSince Jan 1, 2017 Accepting new patients
Exer Medical Corporation CurrentSince Jun 1, 2025 Accepting new patients
Intercommunity Emergency Medical Group CurrentSince Oct 12, 2023 Accepting new patients

Locations

26777 Agoura Rd
Ste 4
Calabasas, CA 91302
Phone (818) 880-2225

235 E 17th St
Costa Mesa, CA 92627
Phone (949) 688-2010

11500 Brookshire Ave
Downey, CA 90241
Phone (562) 904-5000

2381 Rosecrans Ave
Ste 115
El Segundo, CA 90245
Phone (213) 335-7355

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

8110 Mango Ave
Fontana, CA 92335
Phone (909) 427-1303

7000 Boulder Ave
Ste 103
Highland, CA 92346
Phone (515) 441-6271

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

10431 Lemon Ave
Ste N
Rch Cucamonga, CA 91737
Phone (909) 466-6579

25548 The Old Rd
Ste U1
Stevenson Ranch, CA 91381
Phone (661) 556-9020

701 N Wendy Dr
Thousand Oaks, CA 91320
Phone (805) 375-4400

12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1265893317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MANGO AVENUE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "909-427-1303",
            "fax_number": "909-357-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 MANGO AVENUE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "92335",
            "telephone_number": "909-427-1303",
            "fax_number": "909-357-1581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "LESLIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.