Active NPI
John Denis Leonhardt, RPA
- Physician Assistant
- Roslyn, NY
National Provider Identifier
1366644544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002122
- Practice address
- 100 Port Washington Blvd
Roslyn, NY 11576 - Phone
- (516) 562-6000
- NPI assigned
- Jun 1, 2007
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002122 | NY | Primary |
Addresses
Primary practice location
100 Port Washington Blvd
Roslyn, NY 11576
Mailing address
7 Crescent PL
Brentwood, NY 11717-2317
Phone (631) 231-5479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002122 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366644544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CRESCENT PL",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117172317",
"telephone_number": "631-231-5479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PORT WASHINGTON BLVD",
"city": "ROSLYN",
"state": "NY",
"postal_code": "11576",
"telephone_number": "516-562-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONHARDT",
"first_name": "JOHN",
"middle_name": "DENIS",
"name_prefix": "Mr.",
"credential": "RPA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "002122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.