Individual provider Active NPI

Leon Gregory De Masi, M.D., M.P.H.

  • Public Health & General Preventive Medicine Physician
  • Broomall, PA
National Provider Identifier
1518923796
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD025728E Issued in PA
Practice address
1999 Sproul Rd
Suite 21
Broomall, PA 19008-3508
Phone
(610) 353-5840
Fax
(610) 353-3420
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 25MA05089200 NJ
Public Health & General Preventive Medicine Physician 2083P0901X MD025728E PA Primary

Addresses

Primary practice location

1999 Sproul Rd
Suite 21
Broomall, PA 19008-3508

Mailing address

14 Cedar Hollow Dr
Rose Valley, PA 19086-6719
Phone (610) 627-1015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05089200NJMDPublic Health & General Preventive Medicine Physician
MD025728EPAMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1518923796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 CEDAR HOLLOW DR",
            "city": "ROSE VALLEY",
            "state": "PA",
            "postal_code": "190866719",
            "telephone_number": "610-627-1015",
            "fax_number": "610-627-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1999 SPROUL RD",
            "address_2": "SUITE 21",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083508",
            "telephone_number": "610-353-5840",
            "fax_number": "610-353-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MASI",
        "first_name": "LEON",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NJ",
            "license": "25MA05089200",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "PA",
            "license": "MD025728E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.