Active NPI
Brian Guy Leduc, M.D.
- Psychiatry Physician
- Hollywood, FL
National Provider Identifier
1346565736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME153219
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11629A | WY | MD | Psychiatry Physician |
| TL4390 | WY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Broward Hospital District | Current | Accepting new patients | |
| South Broward Hospital District | Current | 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
- bleduc290479@mhsdirect.net
- 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.
-
- Child & Adolescent Psychiatry Physician
- Hollywood, FL
- NPI 1336504075
-
- Home Infusion Therapy Pharmacy
- Miramar, FL
- NPI 1043656614
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.