NPIMap

Individual provider Active NPI

Leon A Yasay Jr., MD

  • Internal Medicine Physician
  • Orange Park, FL
National Provider Identifier
1295719250
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME69763 Issued in FL
Practice address
1555 Kingsley Ave Ste 604
Orange Park, FL 32073-9207
Phone
(904) 541-0670
Fax
(904) 541-0680
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME69763 FL Primary

Addresses

Primary practice location

1555 Kingsley Ave Ste 604
Orange Park, FL 32073-9207

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other identifiers 1

IdentifierTypeStateIssuer
N1008OtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101109000248 FL Practitioner - Internal Medicine 5294819348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

Practice addresses (Care Compare)

1065 Tamiami TRL N
Nokomis, FL 34275-2144
Phone (941) 477-2364

1555 Kingsley Ave
Suite 604
Orange Park, FL 32073-9207
Phone (904) 541-0670

19531 Cochran Blvd
Port Charlotte, FL 33948-2081
Phone (941) 255-3535

2675 Winkler Ave
Fort Myers, FL 33901-9328

2675 Winkler Avenue
Suite 200
Fort Myers, FL 33901-9328

4881 Palm Beach Blvd
Suite 100
Fort Myers, FL 33905-3217
Phone (239) 693-9191

725 S 6TH St
Macclenny, FL 32063-9653
Phone (904) 259-3150

7451 103Rd St
Jacksonville, FL 32210-9300
Phone (904) 683-4968

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME69763FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Aug 2, 2021 Accepting new patients
Millennium Physician Group LLC Internal Medicine CurrentSince Aug 2, 2021 Accepting new patients

Locations

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

1555 Kingsley Ave
Ste 604
Orange Park, FL 32073
Phone (904) 541-0670

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: leon.yasay.1@4290.direct.athenahealth.com

Organizations & group practices 2

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 12

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1295719250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KINGSLEY AVE STE 604",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320739207",
            "telephone_number": "904-541-0670",
            "fax_number": "904-541-0680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASAY",
        "first_name": "LEON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME69763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N1008",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.