Individual provider Active NPI

Leslie Ann De Montrichard, MD

  • Family Medicine Physician
  • San Martin, CA
National Provider Identifier
1386663409
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A50366 Issued in CA
Practice address
90 Highland Ave
VHC San Martin Family Practice Clinic
San Martin, CA 95046-9504
Phone
(408) 686-2217
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A50366 CA Primary

Addresses

Primary practice location

90 Highland Ave
VHC San Martin Family Practice Clinic
San Martin, CA 95046-9504

Mailing address

3210 Paseo Vista Ave
San Martin, CA 95046-9795
Phone (408) 776-9888

Other identifiers 1

IdentifierTypeStateIssuer
00A503660MedicaidCA

Other names 1

  • Leslie Ann De Montrichard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20181018001168 CA Practitioner - Family Practice 8527087527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

7475 Camino Arroyo
Gilroy, CA 95020-7348
Phone (408) 885-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A50366CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Aug 18, 2018 Accepting new patients
County of Santa Clara Family Medicine CurrentSince Aug 18, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

90 Highland Ave
San Martin, CA 95046
Phone (408) 686-2222

Interoperability endpoints

  • Direct secure messaging: ldemontrichard6640@santaclaravalley.direct-ci.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1386663409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 PASEO VISTA AVE",
            "city": "SAN MARTIN",
            "state": "CA",
            "postal_code": "950469795",
            "telephone_number": "408-776-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HIGHLAND AVE",
            "address_2": "VHC SAN MARTIN FAMILY PRACTICE CLINIC",
            "city": "SAN MARTIN",
            "state": "CA",
            "postal_code": "950469504",
            "telephone_number": "408-686-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MONTRICHARD",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A50366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A503660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "DE MONTRICHARD",
            "middle_name": "ANN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Martin, CA

Sources for this page

Verify at the official NPI Registry.