Individual provider Active NPI

Leo Gaston Stinnett Jr., MD

  • Surgery Physician
  • Nogales, AZ
National Provider Identifier
1306864145
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
27159 Issued in AZ
Practice address
1209 W Target Range Rd
Nogales, AZ 85621-2466
Phone
(520) 287-4747
Fax
(520) 285-3136
NPI assigned
Jul 18, 2006
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X J0285 TX
Surgery Physician 208600000X 27159 AZ Primary

Addresses

Primary practice location

1209 W Target Range Rd
Nogales, AZ 85621-2466

Mailing address

1189 E Madera Estates LN
Sahuarita, AZ 85629-6687
Phone (803) 332-1260

Other identifiers 1

IdentifierTypeStateIssuer
454835MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050118000708 AZ Practitioner - General Surgery 3476502352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone (520) 324-4230

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J0285TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mariposa Community Health Center, Inc Current Accepting new patients
Mariposa Community Health Center, Inc Surgery Current Accepting new patients
Mariposa Community Health Center, Inc CurrentSince Nov 30, 2020 Accepting new patients
Mariposa Community Health Center, Inc CurrentSince Nov 30, 2020 Accepting new patients
TMC Medical Network CurrentSince Jun 1, 2025 Accepting new patients
Mariposa Community Health Center, Inc PastSince Nov 30, 2020 Accepting new patients
Lpwallmd PC PastSince Dec 15, 2024 Accepting new patients

Locations

1209 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3135

1835 N Mastick Way
Nogales, AZ 85621
Phone 5202811550 ext. 1180

1852 N Mastick Way
Nogales, AZ 85621

825 N Grand Ave
Ste 100
Nogales, AZ 85621
Phone (520) 761-2128

1103 Circulo Mercado
Ste E
Rio Rico, AZ 85648
Phone 52028115501307

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

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.

Hospital & facility affiliations 1

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1306864145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 E MADERA ESTATES LN",
            "city": "SAHUARITA",
            "state": "AZ",
            "postal_code": "856296687",
            "telephone_number": "803-332-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W TARGET RANGE RD",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856212466",
            "telephone_number": "520-287-4747",
            "fax_number": "520-285-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINNETT",
        "first_name": "LEO",
        "middle_name": "GASTON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J0285",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "27159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "454835",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nogales, AZ

Sources for this page

Verify at the official NPI Registry.