Individual provider Active NPI

Leonard Leonidas

  • Internal Medicine Physician
  • Castleton, NY
National Provider Identifier
1467536391
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
236721 Issued in NY
Practice address
35 Empire State Blvd
Castleton, NY 12033-9777
Phone
(518) 477-2167
Fax
(518) 477-5182
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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 236721 NY Primary
Pediatrics Physician 208000000X 236721 NY

Addresses

Primary practice location

35 Empire State Blvd
Castleton, NY 12033-9777

Mailing address

711 Troy Schenectady Rd
Suite 201
Latham, NY 12110-2442

Other identifiers 1

IdentifierTypeStateIssuer
02684724MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050826000596 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3173554326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Tufts University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

711 Troy Schenectady Rd
Latham, NY 12110-2461

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236721NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC Internal Medicine CurrentSince Aug 1, 2005 Accepting new patients
Community Care Physicians, PC Internal Medicine Past Accepting new patients

Locations

35 Empire State Blvd
Castleton on Hudson, NY 12033
Phone (518) 477-2167

711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

711 Troy Schenectady Rd
Ste 201
Latham, NY 12110

Organizations & group practices 2

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 6

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1467536391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 EMPIRE STATE BLVD",
            "city": "CASTLETON",
            "state": "NY",
            "postal_code": "120339777",
            "telephone_number": "518-477-2167",
            "fax_number": "518-477-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONIDAS",
        "first_name": "LEONARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "236721",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "236721",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02684724",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castleton, NY

Sources for this page

Verify at the official NPI Registry.