Individual provider Active NPI

Jose M Fernandez-Leon, MD

  • Surgery Physician
  • Pensacola, FL
National Provider Identifier
1407811540
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME37945 Issued in FL
Practice address
4531 N Davis Hwy
Pensacola, FL 32503-2770
Phone
(850) 484-5577
Fax
(850) 484-5444
NPI assigned
Apr 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ME37945 FL Primary

Addresses

Primary practice location

4531 N Davis Hwy
Pensacola, FL 32503-2770

Mailing address

2304 Arriviste Way
Pensacola, FL 32504-5901
Phone (850) 484-5577

Other identifiers 2

IdentifierTypeStateIssuer
59116186OtherALBLUE CROSS BLUE SHIELD
17593OtherFLBLUE CROSS BLUE SHIELD

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME37945FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Consultants of West Florida P a Past Accepting new patients
Jose M. Fernandez-Leon Surgery PastSince Sep 1, 2005 Accepting new patients
The Surgery Group PA Surgery Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407811540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 ARRIVISTE WAY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045901",
            "telephone_number": "850-484-5577",
            "fax_number": "850-484-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032770",
            "telephone_number": "850-484-5577",
            "fax_number": "850-484-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-LEON",
        "first_name": "JOSE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME37945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "59116186",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "17593",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

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.

Verify at the official NPI Registry.