Individual provider Active NPI

Peter J Leidl, MD

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1447257688
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A41675 Issued in CA
Practice address
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone
(562) 933-2000
NPI assigned
Jul 1, 2005
Last updated
Oct 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A41675 CA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A41675 CA

Addresses

Primary practice location

2801 Atlantic Ave
Long Beach, CA 90806-1701

Mailing address

2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-2000

Other identifiers 1

IdentifierTypeStateIssuer
00A416750OtherCAMEDI CAL

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
I20040910000568 CA Practitioner - Internal Medicine 8224005269 Reassigns benefits to 1 organization
Practice locations: Long Beach, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Dignity Health Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Davita Medical Group Talbert California, P.C. Internal Medicine Past Accepting new patients
Talbert Medical Group, P.C. Internal Medicine Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

818 W Alondra Blvd
Compton, CA 90220
Phone (310) 537-1137

8311 Florence Ave
Downey, CA 90240
Phone (310) 923-4911

9930 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 964-6229

19066 Magnolia St
Huntington Beach, CA 92646
Phone (714) 378-2225

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

2925 Palo Verde Ave
Long Beach, CA 90815
Phone (562) 421-2757

500 Alamitos Ave
Long Beach, CA 90802
Phone (310) 432-5661

1002 N Fairview St
Santa Ana, CA 92703
Phone (714) 332-1069

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: peterjleidl@hcpca.allscriptsdirect.net

Organizations & group practices 7

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1447257688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDL",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A41675",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A41675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI CAL",
            "identifier": "00A416750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.