Individual provider Active NPI

Leslie Levine, M.D.

  • Internal Medicine Physician
  • Boca Raton, FL
National Provider Identifier
1366481939
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME 64720 Issued in FL
Practice address
660 Glades Rd
Suite 310
Boca Raton, FL 33431-6465
Phone
(561) 361-3133
Fax
(561) 361-9695
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME 64720 FL Primary

Addresses

Primary practice location

660 Glades Rd
Suite 310
Boca Raton, FL 33431-6465

Mailing address

660 Glades Rd
Suite 310
Boca Raton, FL 33431-6465
Phone (561) 361-3133

Other identifiers 3

IdentifierTypeStateIssuer
27972OtherFLBLUE CROSS BLUE SHIELD FLA
WDQ97OtherFLEMPIRE BLUE CROSS BLUE SHIELD
0005525148OtherFLAETNA

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
I20050203000695 FL Practitioner - Internal Medicine 1052362597 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 64720FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Palm Primary Care LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

670 Glades Rd
Ste 110
Boca Raton, FL 33431
Phone (561) 289-9467

660 Glades Rd
Ste 310
Boca Raton, FL 33431
Phone (561) 361-3133

Interoperability endpoints

  • Direct secure messaging: leslie.levine@levine.direct.emedrec.us

Organizations & group practices 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1366481939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 GLADES RD",
            "address_2": "SUITE 310",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316465",
            "telephone_number": "561-361-3133",
            "fax_number": "561-361-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 GLADES RD",
            "address_2": "SUITE 310",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316465",
            "telephone_number": "561-361-3133",
            "fax_number": "561-361-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "LESLIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME 64720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FLA",
            "identifier": "27972",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SHIELD",
            "identifier": "WDQ97",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005525148",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.