Individual provider Active NPI

Nancy Leon, PA-C

  • Medical Physician Assistant
  • San Bernardino, CA
National Provider Identifier
1437489507
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20711 Issued in CA
Practice address
1963 N E St
San Bernardino, CA 92405-3919
Phone
(909) 708-8158
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20711 CA Primary

Addresses

Primary practice location

1963 N E St
San Bernardino, CA 92405-3919

Mailing address

1963 N E St
San Bernardino, CA 92405-3919
Phone (909) 708-8158

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108001152 CA Practitioner - Physician Assistant 7113150939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pih Health PhysiciansGroup PAC ID 8426951328, 616 clinicians
Southern California Emergency MedicineGroup PAC ID 8628128196, 45 clinicians

Practice addresses (Care Compare)

12214 Lakewood Blvd
Suite 110
Downey, CA 90242-2663
Phone (562) 904-4430

12400 Bloomfield Ave
Santa Fe Springs, CA 90670-4750
Phone (562) 967-2820

12675 La Mirada Blvd
Suite 201And401
La Mirada, CA 90638-2200
Phone (562) 903-7339

1400 S Harbor Blvd
La Habra, CA 90631-7577
Phone (714) 879-3400

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone (909) 596-6349

2200 W 3Rd St
Suite 120
Los Angeles, CA 90057-1934
Phone (213) 202-7170

2205 W Beverly Blvd
Montebello, CA 90640-2301
Phone (323) 728-0321

33494 Oak Glen Rd
Yucaipa, CA 92399-2057
Phone (909) 797-8900

Merit-based Incentive Payment System (MIPS)

Final score
78.61 of 100Reported as group
Quality
58.7
Improvement activities
40
Cost
75.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20711CAMDPhysical Rehabilitation Occupational Therapist
PA20711CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Emergency Medicine CurrentSince Oct 14, 2017 Accepting new patients
Pih Health Physicians CurrentSince Dec 1, 2015 Accepting new patients
Pih Health Physicians CurrentSince Dec 1, 2015 Accepting new patients
Southern California Emergency Medicine CurrentSince Oct 14, 2017 Accepting new patients

Locations

1181 S Mount Vernon Ave
Colton, CA 92324
Phone (909) 639-8800

12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339

1407 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-3577

1295 Hamner Ave
Ste C
Norco, CA 92860
Phone (951) 272-6500

33494 Oak Glen Rd
Yucaipa, CA 92399
Phone (909) 797-8900

Organizations & group practices 6

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": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1437489507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 N E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053919",
            "telephone_number": "909-708-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 N E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924053919",
            "telephone_number": "909-708-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "NANCY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.