Individual provider Active NPI

Leandro Tuazon Cabanilla, MD

  • Surgery Physician
  • Kennewick, WA
National Provider Identifier
1386754265
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD00032181 Issued in WA
Practice address
3730 Plaza Way
Kennewick, WA 99338-2718
Phone
(509) 221-6550
Fax
(509) 221-6230
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD00032181 WA Primary

Addresses

Primary practice location

3730 Plaza Way
Kennewick, WA 99338-2718

Mailing address

3730 Plaza Way
Kennewick, WA 99338-2718
Phone (509) 221-6550

Other identifiers 2

IdentifierTypeStateIssuer
1122266MedicaidWA
203198509OtherBLUE CROSS SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL leandro.cabanilla@trioshealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060210000302 WA Practitioner - General Surgery 4981619087 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00032181WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RCCH Trios Health LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111

216 W 10th Ave
Ste 202
Kennewick, WA 99336
Phone (509) 221-5510

216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520

3730 Plaza Way
Kennewick, WA 99338
Phone (509) 221-6350

521 N Young St
Kennewick, WA 99336
Phone (509) 221-5222

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1386754265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 PLAZA WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-221-6550",
            "fax_number": "509-586-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 PLAZA WAY",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-221-6550",
            "fax_number": "509-221-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABANILLA",
        "first_name": "LEANDRO",
        "middle_name": "TUAZON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00032181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1122266",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SHIELD",
            "identifier": "203198509",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "leandro.cabanilla@trioshealth.org",
            "affiliation": "N",
            "endpointDescription": "hospital email",
            "address_1": "3730 Plaza Way",
            "city": "Kennewick",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993382718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.