Individual provider Active NPI

Leo F Kenzakowski, MD

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1457342255
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101233641 Issued in VA
Practice address
1602 Skipwith Rd
Richmond, VA 23229-5205
Phone
(804) 289-4500
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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 0101233641 VA Primary
Pediatrics Physician 208000000X 0101233641 VA

Addresses

Primary practice location

1602 Skipwith Rd
Richmond, VA 23229-5205

Mailing address

4050 Innslake Dr
Suite 308
Glen Allen, VA 23060-3327
Phone (804) 521-5315

Other identifiers 8

IdentifierTypeStateIssuer
6230121OtherVACIGNA
10228905MedicaidVA
1457342255MedicaidVA
302011OtherVAANTHEM
P00601102OtherVAMEDICARE RAILROAD
10228905OtherVAANTHEM
P00606712OtherVARR MEDICARE
631615OtherVASOUTHERN HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20051110000904 VA Practitioner - Internal Medicine 9335167006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

1602 Skipwith Rd
Richmond, VA 23229-5205
Phone (804) 289-4500

Hospital & facility affiliations

  • Henrico Doctors' Hospital Hospital, Richmond, VA, CCN 490118

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as individual
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101233641VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Intensivist Services PC Internal Medicine CurrentSince Feb 6, 2019 Accepting new patients
Virginia Hospitalists Inc Internal Medicine Past Accepting new patients
Commonwealth Primary Care Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Commonwealth Hosp SVCS Internal Medicine PastSince Oct 1, 2007 Accepting new patients

Locations

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

7101 Jahnke Rd
Ste 611
Richmond, VA 23225
Phone (804) 327-4046

7101 Jahnke Rd
#611
Richmond, VA 23225
Phone (540) 498-4000

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

7700 E Parham Rd
Richmond, VA 23294
Phone (804) 289-4852

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1457342255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DR",
            "address_2": "SUITE 308",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603327",
            "telephone_number": "804-521-5315",
            "fax_number": "804-521-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295205",
            "telephone_number": "804-289-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENZAKOWSKI",
        "first_name": "LEO",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101233641",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101233641",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6230121",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10228905",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457342255",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "302011",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00601102",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "10228905",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00606712",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "631615",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.