NPIMap

Individual provider Active NPI

Eliezer R De Leon, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1578536009
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
038489 Issued in MI
Practice address
17000 Hubbard Dr
Dearborn, MI 48126-4258
Phone
(313) 982-4351
Fax
(313) 982-4370
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 038489 MI Primary

Addresses

Primary practice location

17000 Hubbard Dr
Dearborn, MI 48126-4258

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edeleon113701@direct.beaumont.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091223000473 MI Practitioner - Internal Medicine 3779661988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Internists,P.C.Group PAC ID 5597719468, 4 clinicians

Practice addresses (Care Compare)

32320 Michigan Ave
Wayne, MI 48184-1423
Phone (734) 641-3630

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038489MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Internists,P.C. Internal Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

21801 Goddard Rd
Taylor, MI 48180
Phone (734) 287-3830

32320 Michigan Ave
Wayne, MI 48184
Phone (734) 641-3630

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.

Hospital & facility affiliations 7

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1578536009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1863",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 HUBBARD DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264258",
            "telephone_number": "313-982-4351",
            "fax_number": "313-982-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "ELIEZER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "038489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edeleon113701@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "17000 Hubbard Dr",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481264258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.