Individual provider Active NPI

Grigory Leontyev, MD

  • Surgery Physician
  • Oceanside, NY
National Provider Identifier
1346322054
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
228112-1 Issued in NY
Practice address
3304 Park Ave
Oceanside, NY 11572-4352
Phone
(516) 270-2126
Fax
(516) 255-2072
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 228112-1 NY Primary

Addresses

Primary practice location

3304 Park Ave
Oceanside, NY 11572-4352

Mailing address

3304 Park Ave
Oceanside, NY 11572-4352
Phone (516) 270-2126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200817001683 NY Practitioner - General Surgery 5991121311 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228112-1NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince May 29, 2020 Accepting new patients
Nightwatch Medicine PLLC CurrentSince Sep 10, 2024 Accepting new patients
Bronxcare Health System CurrentSince May 29, 2020 Accepting new patients
Bronxcare Health System Current Accepting new patients
Lwhmedical PC CurrentSince Sep 10, 2024 Accepting new patients
Jamaica Hospital Medical Center Past Accepting new patients

Locations

1811 Hone Ave
Bronx, NY 10461
Phone (516) 499-9016

1276 Fulton Ave
Rm 219
Bronx, NY 10456

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

Interoperability endpoints

  • Direct secure messaging: gleontyev5969@direct.medisys.org

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346322054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 PARK AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115724352",
            "telephone_number": "516-270-2126",
            "fax_number": "516-255-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 PARK AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115724352",
            "telephone_number": "516-270-2126",
            "fax_number": "516-255-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONTYEV",
        "first_name": "GRIGORY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "228112-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.