Individual provider Active NPI

Leonid Eduard Lerner, M.D., PH.D.

  • Ophthalmology Physician
  • Newport Beach, CA
National Provider Identifier
1396798484
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A54458 Issued in CA
Practice address
3 Corporate Plaza Dr
Suite 150
Newport Beach, CA 92660-7905
Phone
(949) 721-1701
Fax
(949) 612-1910
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A54458 CA Primary

Addresses

Primary practice location

3 Corporate Plaza Dr
Suite 150
Newport Beach, CA 92660-7905

Mailing address

1441 Avocado Ave
Ste 204
Newport Beach, CA 92660-7703
Phone (949) 721-1701

Other identifiers 2

IdentifierTypeStateIssuer
CB770XOtherCAMEDICARE PTAN
CB770YOtherCAMEDICARE PTAN

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
I20060821000190 CA Practitioner - Ophthalmology 4688637135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1441 Avocado Ave
Suite 204
Newport Beach, CA 92660-7703
Phone (949) 721-1701

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54458CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Retinal and Macular Diseases, Inc. Ophthalmology CurrentSince Oct 23, 2009 Accepting new patients
University of California Irvine Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

3 Corporate Plaza Dr
Ste 150
Newport Beach, CA 92660
Phone (949) 395-3112

1441 Avocado Ave
Ste 204
Newport Beach, CA 92660
Phone (949) 644-1661

9201 W Sunset Blvd
Ste 709
West Hollywood, CA 90069
Phone (310) 275-5533

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1396798484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 AVOCADO AVE",
            "address_2": "STE 204",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607703",
            "telephone_number": "949-721-1701",
            "fax_number": "949-612-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CORPORATE PLAZA DR",
            "address_2": "SUITE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607905",
            "telephone_number": "949-721-1701",
            "fax_number": "949-612-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERNER",
        "first_name": "LEONID",
        "middle_name": "EDUARD",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A54458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB770X",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB770Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.