Individual provider Active NPI

Stephanie M Leiva, M.D.

  • Gynecology Physician
  • Orlando, FL
National Provider Identifier
1346602000
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME160822 Issued in FL
Practice address
930 Lake Baldwin LN
Orlando, FL 32814-6651
Phone
(407) 898-1500
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME160822 FL
Gynecology Physician 207VG0400X ME160822 FL Primary

Addresses

Primary practice location

930 Lake Baldwin LN
Orlando, FL 32814-6651

Mailing address

930 Lake Baldwin LN
Orlando, FL 32814-6651
Phone (407) 898-1500

Other identifiers 1

IdentifierTypeStateIssuer
117419300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210616000074 PA Practitioner - Obstetrics/Gynecology 1850718941 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jul 2, 2021 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jul 2, 2021 Accepting new patients
Marjorie Nolan Cohn LLC Past Accepting new patients
Allara Medical Group PA Obstetrics & Gynecology Past Accepting new patients

Locations

25 Monument Rd
Ste 295
York, PA 17403
Phone (717) 356-5864

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

35 Monument Rd
Ste 206
York, PA 17403
Phone (717) 741-8011

Interoperability endpoints

  • Direct secure messaging: stephanie.leiva@335000925634564.direct.elationemr.com

Organizations & group practices 5

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": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1346602000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 LAKE BALDWIN LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146651",
            "telephone_number": "407-898-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 LAKE BALDWIN LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328146651",
            "telephone_number": "407-898-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIVA",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME160822",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME160822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117419300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.