Individual provider Active NPI

Leonardo Villegas, M.D.

  • Surgical Oncology Physician
  • Pensacola, FL
National Provider Identifier
1508934555
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
ME110757 Issued in FL
Practice address
730 Bayfront Pkwy Ste 5a
Pensacola, FL 32502-6250
Phone
(850) 432-5488
Fax
(850) 432-5228
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2009-01041 NC
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Oncology Physician 2086X0206X ME110757 FL Primary

Addresses

Primary practice location

730 Bayfront Pkwy Ste 5a
Pensacola, FL 32502-6250

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6014

Other practice location 1

550 Redstone Ave W Ste 200A
Crestview, FL 32536-6428
Phone (850) 432-5488

Other identifiers 3

IdentifierTypeStateIssuer
14FC8OtherFLBCBSFL
592-21627OtherALBCBS
003997200MedicaidFL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111013000555 FL Practitioner - Surgical OncologyPractitioner - General Surgery 0941351316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

550 W Redstone Ave
Suite 200
Crestview, FL 32536-6429
Phone (850) 682-6122

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009-01041NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. Current Accepting new patients
Sacred Heart Medical Group Surgical Oncology CurrentSince Oct 10, 2021 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

550 Redstone Ave W
Ste 200
Crestview, FL 32536
Phone (850) 682-6122

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

730 Bayfront Pkwy
Ste 4A
Pensacola, FL 32502
Phone (850) 432-5488

Interoperability endpoints

  • Direct secure messaging: leonardo.villegas.1@9582.direct.athenahealth.com

Organizations & group practices 3

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 1

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1508934555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6014",
            "fax_number": "904-450-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 BAYFRONT PKWY STE 5A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325026250",
            "telephone_number": "850-432-5488",
            "fax_number": "850-432-5228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Redstone Ave W Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325366428",
            "country_code": "US",
            "telephone_number": "850-432-5488",
            "fax_number": "850-432-5228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "LEONARDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2009-01041",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "FL",
            "license": "ME110757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "14FC8",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "592-21627",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003997200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.