Active NPI
Aurea Andrea Tancungco De Leon, M.D
- Pediatrics Physician
- Mount Vernon, NY
National Provider Identifier
1447279708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 224575
- Practice address
- 107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550 - Phone
- (914) 699-7200
- Fax
- (914) 699-0837
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- 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 | 224575 | NY | Primary |
Addresses
Primary practice location
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Mailing address
107 West 4TH Street
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550
Phone (914) 699-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 224575 | Other | NY | LICENSE # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 224575 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1447279708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WEST 4TH STREET",
"address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-699-7200",
"fax_number": "914-699-0837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WEST 4TH STREET",
"address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "10550",
"telephone_number": "914-699-7200",
"fax_number": "914-699-0837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LEON",
"first_name": "AUREA ANDREA",
"middle_name": "TANCUNGCO",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "224575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "224575",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Vernon, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.