Individual provider Active NPI

Brian Guy Leduc, M.D.

  • Psychiatry Physician
  • Hollywood, FL
National Provider Identifier
1346565736
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME153219 Issued in FL
Practice address
1150 N 35TH Ave Ste 560
Hollywood, FL 33021-5431
Phone
(954) 265-1370
Fax
(954) 265-1375
NPI assigned
Mar 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 11629A WY
Psychiatry Physician 2084P0800X TL4390 WY
Psychiatry Physician 2084P0800X ME153219 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X 36088 SC

Addresses

Primary practice location

1150 N 35TH Ave Ste 560
Hollywood, FL 33021-5431

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bleduc290479@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220104001538 FL Practitioner - Psychiatry 2567696016 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11629AWYMDPsychiatry Physician
TL4390WYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Oct 5, 2021 Accepting new patients
South Broward Hospital District CurrentSince Oct 5, 2021 Accepting new patients

Locations

1150 N 35th Ave
Ste 560
Hollywood, FL 33021
Phone (954) 265-1260

3440 Hollywood Blvd
Ste 360
Hollywood, FL 33021
Phone (954) 276-9200

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Interoperability endpoints

  • Direct secure messaging: bleduc290479@mhsdirect.net
  • Direct secure messaging: bleduc33075@direct.crmcwy.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1346565736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 560",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215431",
            "telephone_number": "954-265-1370",
            "fax_number": "954-265-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDUC",
        "first_name": "BRIAN",
        "middle_name": "GUY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "11629A",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WY",
            "license": "TL4390",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME153219",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "36088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bleduc290479@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "1150 N 35th Ave Ste 560",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.