Active NPI
Philip J Leonardelli, MD
- Pediatrics Physician
- Rio Rancho, NM
National Provider Identifier
1437159993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 86-266
- Practice address
- 1704 Southern Blvd SE
Rio Rancho, NM 87124-3505 - Phone
- (505) 994-3256
- Fax
- (603) 947-3608
- NPI assigned
- Jul 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 86-266 | NM | Primary |
Addresses
Primary practice location
1704 Southern Blvd SE
Rio Rancho, NM 87124-3505
Mailing address
115 2ND St SE
Rio Rancho, NM 87124-2650
Phone (505) 891-3157
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86-266 | NM | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437159993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 2ND ST SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871242650",
"telephone_number": "505-891-3157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1704 SOUTHERN BLVD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871243505",
"telephone_number": "505-994-3256",
"fax_number": "603-947-3608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONARDELLI",
"first_name": "PHILIP",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "86-266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rio Rancho, NM
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.