Individual provider Active NPI

Leonel Jorge Favio Estofan, MD

  • Epilepsy Physician
  • Edinburg, TX
National Provider Identifier
1417339409
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Epilepsy PhysicianTaxonomy code 2084E0001X
License
S9499 Issued in TX
Practice address
2821 Michaelangelo Dr Ste 305
Edinburg, TX 78539-1405
Phone
(956) 362-8100
Fax
(956) 362-8105
NPI assigned
Jun 25, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X S9499 TX
Epilepsy Physician 2084E0001X S9499 TX Primary

Addresses

Primary practice location

2821 Michaelangelo Dr Ste 305
Edinburg, TX 78539-1405

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 362-8100

Other practice location 1

505 Angelita Dr Ste 14
Weslaco, TX 78599-8694
Phone (956) 362-3720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210615000979 TX Practitioner - EpileptologistsPractitioner - Neurology 1658677653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EpileptologistsAlso: Neurology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Renaissance Medical FoundationGroup PAC ID 1153409867, 178 clinicians

Practice addresses (Care Compare)

2821 W Michaelangelo Dr
Suite 305
Edinburg, TX 78539-1405
Phone (956) 362-8100

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869
  • South Texas Health System Hospital, Edinburg, TX, CCN 450119

Merit-based Incentive Payment System (MIPS)

Final score
98.1 of 100Reported as group
Quality
86
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renaissance Medical Foundation CurrentSince Jul 19, 2021 Accepting new patients

Locations

2821 W Michaelangelo Dr
Ste 302
Edinburg, TX 78539
Phone (361) 980-1244

2821 W Michaelangelo Dr
Ste 305
Edinburg, TX 78539
Phone (956) 362-8100

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

2821 W Michaelangelo Dr
Ste 200
Edinburg, TX 78539
Phone (956) 362-8215

1401 E 8th St
Weslaco, TX 78596
Phone (956) 581-0303

505 Angelita Dr
Ste 14
Weslaco, TX 78599
Phone (956) 362-3720

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.

Hospital & facility affiliations 5

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": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1417339409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-362-8100",
            "fax_number": "956-362-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 MICHAELANGELO DR STE 305",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391405",
            "telephone_number": "956-362-8100",
            "fax_number": "956-362-8105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 Angelita Dr Ste 14",
            "address_purpose": "LOCATION",
            "city": "Weslaco",
            "state": "TX",
            "postal_code": "785998694",
            "country_code": "US",
            "telephone_number": "956-362-3720",
            "fax_number": "956-362-3737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTOFAN",
        "first_name": "LEONEL",
        "middle_name": "JORGE FAVIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "S9499",
            "primary": false
        },
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "TX",
            "license": "S9499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.