Organization Active NPI

Leon Medical LLC

  • Primary Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1457201147
Registry record updated Mar 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LEON MEDICAL LLC
Practice address
3430 E Flamingo Rd Ste 104
Las Vegas, NV 89121-5070
Phone
(702) 331-2094
Fax
(702) 331-3612
NPI assigned
Feb 2, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2026

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

Authorized official

Name
Amauri Santiago Rosales Ponce de Leon, NPNPI 1205454295
Title
Owner
Phone
(702) 331-2094

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3430 E Flamingo Rd Ste 104
Las Vegas, NV 89121-5070

Mailing address

3430 E Flamingo Rd Ste 104
Las Vegas, NV 89121-5070
Phone (702) 331-2094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260330003808 NV Part B Supplier - Clinic/Group Practice 4486139292 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2343987Leon Medical LLC3430 E Flamingo Rd Suite 104, Las Vegas, NV 89121Certificate of waiverMay 13, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772323200000",
    "number": "1457201147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215070",
            "telephone_number": "702-331-2094",
            "fax_number": "702-331-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E FLAMINGO RD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215070",
            "telephone_number": "702-331-2094",
            "fax_number": "702-331-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEON MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-02",
        "last_updated": "2026-03-01",
        "certification_date": "2026-03-01",
        "status": "A",
        "authorized_official_last_name": "ROSALES PONCE DE LEON",
        "authorized_official_first_name": "AMAURI",
        "authorized_official_middle_name": "SANTIAGO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-331-2094",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.