Individual provider Active NPI

Ivan Rigal Leyva, APRN

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1508625435
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11031627 Issued in FL
Practice address
4430 Leto Lakes Blvd Apt 206
Tampa, FL 33614-3723
Phone
(229) 251-7650
NPI assigned
Mar 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11031627 FL Primary

Addresses

Primary practice location

4430 Leto Lakes Blvd Apt 206
Tampa, FL 33614-3723

Mailing address

4430 Leto Lakes Blvd Apt 206
Tampa, FL 33614-3723
Phone (229) 251-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240626003640 FL Practitioner - Nurse Practitioner 0244774669 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11031627FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medway Medical Centers of Clearwater LLC CurrentSince Jul 13, 2024 Accepting new patients

Locations

1012 Druid Rd E
Clearwater, FL 33756
Phone (727) 443-4242

Organizations & group practices 1

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": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1508625435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 LETO LAKES BLVD APT 206",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143723",
            "telephone_number": "229-251-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 LETO LAKES BLVD APT 206",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336143723",
            "telephone_number": "229-251-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIGAL LEYVA",
        "first_name": "IVAN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11031627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.