Individual provider Active NPI

Vivian H Leung, M.D.

  • Family Medicine Physician
  • Meriden, CT
National Provider Identifier
1447592134
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56028 Issued in CT
Practice address
435 Lewis Ave
Meriden, CT 06451-2101
Phone
(203) 694-8200
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6626 GA
Family Medicine Physician 207Q00000X 56028 CT Primary

Addresses

Primary practice location

435 Lewis Ave
Meriden, CT 06451-2101

Mailing address

4500 N Shallowford Rd
Atlanta, GA 30338-6476

Other practice location 1

4500 N Shallowford Rd
Atlanta, GA 30338-6476
Phone (404) 778-6920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20180904000557 CT Practitioner - Internal Medicine 0042513038 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6626GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midstate Medical Center CurrentSince Sep 1, 2018 Accepting new patients
Midstate Medical Center CurrentSince Sep 1, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 1, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Sep 1, 2018 Accepting new patients

Locations

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

Organizations & group practices 4

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1447592134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 N SHALLOWFORD RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 LEWIS AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512101",
            "telephone_number": "203-694-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4500 N Shallowford Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303386476",
            "country_code": "US",
            "telephone_number": "404-778-6920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "VIVIAN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "6626",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "56028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

Verify at the official NPI Registry.