Individual provider Active NPI

David W. Leece, M.D.

  • Family Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1528037561
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G61315 Issued in CA
Practice address
35 Casa St
Suite 170
San Luis Obispo, CA 93405-1818
Phone
(805) 540-5035
Fax
(805) 540-5036
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G61315 CA Primary

Addresses

Primary practice location

35 Casa St
Suite 170
San Luis Obispo, CA 93405-1818

Mailing address

35 Casa St
Suite 170
San Luis Obispo, CA 93405-1818
Phone (805) 540-5035

Other identifiers 3

IdentifierTypeStateIssuer
00G613150MedicaidCA
00G613150OtherCABLUE SHIELD OF CALIFORNIA
G61315OtherCABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100304000114 CA Practitioner - Family Practice 6507874104 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61315CAMDGeneral Practice Dentistry
G61315CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Communities Physician Network, Inc. CurrentSince Apr 26, 2015 Accepting new patients
San Luis Primary Care Medical Group, Inc. Family Medicine PastSince Nov 30, 2000 Accepting new patients

Locations

4580 California Ave
Bakersfield, CA 93309
Phone (661) 327-4411

35 Casa St
Ste 170
Sn Luis Obisp, CA 93405
Phone (805) 540-5035

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: david.leece.p8@direct.bfmc.nextgenshare.com

Organizations & group practices 2

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1528037561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CASA ST",
            "address_2": "SUITE 170",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051818",
            "telephone_number": "805-540-5035",
            "fax_number": "805-540-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CASA ST",
            "address_2": "SUITE 170",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051818",
            "telephone_number": "805-540-5035",
            "fax_number": "805-540-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEECE",
        "first_name": "DAVID",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G61315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G613150",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00G613150",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "G61315",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.