NPIMap

Individual provider Active NPI

Pablo Bernardi Leitzman

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1528528510
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
71334 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-3456
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 71334 MN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

1415 Tulane Ave
New Orleans, LA 70112-2600
Phone (504) 988-5263

Other practice location 2

1430 Tulane Ave # Sl50
New Orleans, LA 70112-2632
Phone (504) 988-7809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220606002103 MN Practitioner - Internal Medicine 0345628251 Reassigns benefits to 3 organizations
I20221221001659 WI Practitioner - Internal MedicinePractitioner - Hospitalist 0345628251 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-4786

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71334MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jul 11, 2022 Accepting new patients
St. Croix Regional Medical Center CurrentSince Oct 1, 2022 Accepting new patients
Healthpartners RC CurrentSince May 2, 2023 Accepting new patients
Group Health, Inc. CurrentSince Jul 11, 2022 Accepting new patients
Healthpartners RC CurrentSince May 2, 2023 Accepting new patients
St. Croix Regional Medical Center CurrentSince Oct 1, 2022 Accepting new patients
Group Health, Inc. Current Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

100 Healthy Way
Olivia, MN 56277
Phone (320) 523-1261

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Organizations & group practices 7

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1528528510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Tulane Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122600",
            "country_code": "US",
            "telephone_number": "504-988-5263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1430 Tulane Ave # Sl50",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122632",
            "country_code": "US",
            "telephone_number": "504-988-7809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEITZMAN",
        "first_name": "PABLO",
        "middle_name": "BERNARDI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "71334",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.