Individual provider Active NPI

Jessie Fuentes Leonard, CRNP

  • Family Nurse Practitioner
  • York, PA
National Provider Identifier
1487087664
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R205536 Issued in MD
Practice address
1401 Roosevelt Ave
York, PA 17404
Phone
(717) 812-7000
Fax
(717) 767-8985
NPI assigned
Aug 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP013065 PA
Family Nurse Practitioner 363LF0000X R205536 MD Primary

Addresses

Primary practice location

1401 Roosevelt Ave
York, PA 17404

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405

Other practice location 1

605 S George St
Suite 200
York, PA 17401-3160
Phone (717) 851-2334

Other practice location 2

605 S George St
Suite 200
York, PA 17401-3160
Phone (717) 851-2334

Other practice location 3

14A Mount Carmel Rd
Parkton, MD 21120-9721
Phone (443) 491-3333

Other identifiers 1

IdentifierTypeStateIssuer
3002240OtherPAHIGHMARK BLUE SHIELD-FREEDOM BLUE

Other names 1

  • Jessie Ondina Fuentes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130924000077 PA Practitioner - Nurse Practitioner 4880838341 Reassigns benefits to 1 organization
I20180124000369 MD Practitioner - Nurse Practitioner 4880838341 Reassigns benefits to 1 organization
I20180124000816 DC Practitioner - Nurse Practitioner 4880838341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
University of Maryland St Joseph Medical Group LLCGroup PAC ID 4880846179, 288 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Forest Hill, MD 21050-1758

14 A Mount Carmel Rd
Parkton, MD 21120-9721
Phone (410) 337-4877

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Rosedale, MD, CCN 217094
  • University of MD St Joseph Medical Center Hospital, Towson, MD, CCN 210063
  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Aug 14, 2023 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Aug 14, 2023 Accepting new patients
Wellspan Medical Group CurrentSince Feb 4, 2019 Accepting new patients
Wellspan Medical Group CurrentSince Feb 4, 2019 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

14A Mount Carmel Rd
Parkton, MD 21120
Phone (410) 357-9283

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

1401 Roosevelt Ave
York, PA 17404
Phone (717) 356-6250

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

605 S George St
Ste 200
York, PA 17401
Phone (717) 851-2334

Interoperability endpoints

  • Direct secure messaging: jleonard1027746@direct.umm.edu

Organizations & group practices 8

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": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1487087664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 ROOSEVELT AVE",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17404",
            "telephone_number": "717-812-7000",
            "fax_number": "717-767-8985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 S George St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174013160",
            "country_code": "US",
            "telephone_number": "717-851-2334",
            "fax_number": "717-851-3498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 S George St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174013160",
            "country_code": "US",
            "telephone_number": "717-851-2334",
            "fax_number": "717-851-3498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14A Mount Carmel Rd",
            "address_purpose": "LOCATION",
            "city": "Parkton",
            "state": "MD",
            "postal_code": "211209721",
            "country_code": "US",
            "telephone_number": "443-491-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "JESSIE",
        "middle_name": "FUENTES",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013065",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R205536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD-FREEDOM BLUE",
            "identifier": "3002240",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "FUENTES",
            "middle_name": "ONDINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.