Camilo Leal, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

83459 Issued in GA

Practice address

20 Herrell Rd
Villa Rica, GA 30180

Phone

(770) 812-3530

NPI assigned

May 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Psychiatry

Education

Morehouse School of Medicine, 2014

Medicare assignment

May accept Medicare assignment

Group practices

TMC-Behavioral Health of West GeorgiaGroup PAC ID 2163714635, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• TMC-Behavioral Health of West Georgia

  dba Behavioral Health of West Georgia

  • Geriatric Psychiatry Physician
  • Villa Rica, GA
  • NPI 1356795462
  Medicare reassignment Care Compare group NPD
• TMC/Villa Rica Hospital, Inc

  dba Tanner Health System

  • General Acute Care Hospital
  • Villa Rica, GA
  • NPI 1851388748
  NPD (past)

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1306257126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527",
            "telephone_number": "770-812-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "770-812-3530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4037 NW 86th Ter Rm 3154",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326069277",
            "country_code": "US",
            "telephone_number": "352-265-4357",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4037 NW 86th Ter Rm 3154",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326069277",
            "country_code": "US",
            "telephone_number": "352-265-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAL",
        "first_name": "CAMILO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME133544",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "83459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.