NPIMap

Individual provider Active NPI

Leo Takashi Yamaguchi, MD

  • Nephrology Physician
  • Lubbock, TX
National Provider Identifier
1467912709
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
V2340 Issued in TX
Practice address
3601 4TH St # Ms 9410
Lubbock, TX 79430-9000
Phone
(806) 743-6916
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A17721 CA
Nephrology Physician 207RN0300X V2340 TX Primary

Addresses

Primary practice location

3601 4TH St # Ms 9410
Lubbock, TX 79430-9000

Mailing address

3100 N. Tenaya Way
Graduate Medical Education
Las Vegas, NV 89128-0431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723004177 TX Practitioner - Nephrology 5890023493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Creighton University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9410
Phone (806) 743-3150

Hospital & facility affiliations

  • Fresenius Medical Care Lubbock Dialysis facility, Lubbock, TX, CCN 452568
  • Lubbock Dialysis Center-Redbud Dialysis facility, Lubbock, TX, CCN 452792
  • FKC Northeast Lubbock Dialysis facility, Lubbock, TX, CCN 742599
  • Fresenius Kidney Care Stanbaugh Memorial Dialysis facility, Lamesa, TX, CCN 742520
  • University Medical Center Hospital, Lubbock, TX, CCN 450686

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A17721CAMDNephrology Physician
V2340TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Nephrology CurrentSince Sep 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Sep 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince Jul 7, 2024 Accepting new patients
Covenant Medical Group PastSince Jul 7, 2024 Accepting new patients

Locations

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Stop 9410
Lubbock, TX 79430
Phone (806) 743-3155

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

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 9

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1467912709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 N. TENAYA WAY",
            "address_2": "GRADUATE MEDICAL EDUCATION",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST # MS 9410",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794309000",
            "telephone_number": "806-743-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAGUCHI",
        "first_name": "LEO",
        "middle_name": "TAKASHI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A17721",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "V2340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.