Individual provider Active NPI

Michelle Deleon, M.D.

  • Colon & Rectal Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1619261591
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME152038 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone
(904) 953-2000
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD464565 PA
Colon & Rectal Surgery Physician 208C00000X MD464565 PA
Student in an Organized Health Care Education/Training Program 390200000X NJ
Colon & Rectal Surgery Physician 208C00000X ME152038 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

60 Township Line Rd
Elkins Park, PA 19027-2220
Phone (215) 663-6422

Other practice location 2

1 Robert Wood Johnson Pl
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdeleon1457674@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210922000421 FL Practitioner - Colorectal Surgery (Proctology) 5890066518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
74.85
Promoting interoperability
100
Improvement activities
40
Cost
72.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD464565PAMDSurgery Physician
ME152038FLMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Aug 25, 2021 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Aug 25, 2021 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

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.

Hospital & facility affiliations 1

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1619261591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Township Line Rd",
            "address_purpose": "LOCATION",
            "city": "Elkins Park",
            "state": "PA",
            "postal_code": "190272220",
            "country_code": "US",
            "telephone_number": "215-663-6422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Robert Wood Johnson Pl",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011928",
            "country_code": "US",
            "telephone_number": "732-828-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELEON",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD464565",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "PA",
            "license": "MD464565",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME152038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdeleon1457674@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.