Individual provider Active NPI

Aurora Leyva Richter, MD

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1588849335
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME100592 Issued in FL
Practice address
9857 Old Saint Augustine Rd Ste 4
Jacksonville, FL 32257-8821
Phone
(904) 861-1900
Fax
(904) 292-9264
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME100592 FL Primary

Addresses

Primary practice location

9857 Old Saint Augustine Rd Ste 4
Jacksonville, FL 32257-8821

Mailing address

9857 Old Saint Augustine Rd Ste 1
Jacksonville, FL 32257-8821
Phone (904) 260-4461

Other identifiers 2

IdentifierTypeStateIssuer
14229OtherFLBLUE CROSS BLUE SHIELD
280348800MedicaidFL

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME100592FLMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1588849335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9857 OLD SAINT AUGUSTINE RD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578821",
            "telephone_number": "904-260-4461",
            "fax_number": "904-292-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9857 OLD SAINT AUGUSTINE RD STE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578821",
            "telephone_number": "904-861-1900",
            "fax_number": "904-292-9264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "AURORA",
        "middle_name": "LEYVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME100592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14229",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280348800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.