Individual provider Active NPI

Dennis R Leahy, M.D.

  • Interventional Cardiology Physician
  • Escondido, CA
National Provider Identifier
1619970480
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
G29437 Issued in CA
Practice address
1955 W Citracado Pkwy
Suite 300
Escondido, CA 92029-4113
Phone
(760) 743-0546
Fax
(760) 743-8837
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G29437 CA
Interventional Cardiology Physician 207RI0011X G29437 CA Primary

Addresses

Primary practice location

1955 W Citracado Pkwy
Suite 300
Escondido, CA 92029-4113

Mailing address

PO Box 28199
San Diego, CA 92198-0199
Phone (858) 673-2574

Other identifiers 2

IdentifierTypeStateIssuer
060020690OtherRR MEDICARE
1619970480MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G29437CAMDInterventional Cardiology Physician
29437CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1619970480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28199",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921980199",
            "telephone_number": "858-673-2574",
            "fax_number": "858-618-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W CITRACADO PKWY",
            "address_2": "SUITE 300",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294113",
            "telephone_number": "760-743-0546",
            "fax_number": "760-743-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "DENNIS",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G29437",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G29437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060020690",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619970480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.