Individual provider Active NPI

Eric G Leveen, M.D.

  • Surgery Physician
  • Palo Alto, CA
National Provider Identifier
1487619490
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G155885 Issued in CA
Practice address
1515 El Camino Real Ste D
Palo Alto, CA 94306-1000
Phone
(650) 600-9838
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G155885 CA Primary
Surgery Physician 208600000X 9346 SC

Addresses

Primary practice location

1515 El Camino Real Ste D
Palo Alto, CA 94306-1000

Mailing address

1515 El Camino Real Ste D
Palo Alto, CA 94306-1000
Phone (650) 600-9838

Other practice location 1

PMB 18
Saipan, MP 96950
Phone (670) 783-0641

Other practice location 2

2750 Laurel St Ste 200
Columbia, SC 29204-2047
Phone (803) 409-7130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP, GU2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150625000763 MP Practitioner - General Surgery 5597724708 Reassigns benefits to 1 organization
I20161027001514 GU Practitioner - General Surgery 5597724708 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G155885CAMDSurgery Physician
9346SCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hafa Specialist Group LLP CurrentSince Dec 5, 2016 Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Jun 26, 2016 Accepting new patients
Guam Memorial Hospital CurrentSince May 10, 2017 Accepting new patients
Guam Memorial Hospital CurrentSince May 10, 2017 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

280 Pale San Vitores Rd
Tamuning, GU 96913
Phone (671) 647-4542

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1487619490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 EL CAMINO REAL STE D",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061000",
            "telephone_number": "650-600-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 EL CAMINO REAL STE D",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061000",
            "telephone_number": "650-600-9838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PMB 18",
            "address_purpose": "LOCATION",
            "city": "Saipan",
            "state": "MP",
            "postal_code": "96950",
            "country_code": "US",
            "telephone_number": "670-783-0641",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2750 Laurel St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292042047",
            "country_code": "US",
            "telephone_number": "803-409-7130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVEEN",
        "first_name": "ERIC",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G155885",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "9346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.