Individual provider Active NPI

Jacqueline Marie Leon Leon, M.D.

  • Pediatrics Physician
  • Laguna Niguel, CA
National Provider Identifier
1629398490
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A111658 Issued in CA
Practice address
25500 Rancho Niguel Rd Ste 110
Laguna Niguel, CA 92677-7373
Phone
(949) 448-8821
Fax
(949) 448-8831
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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 A111658 CA Primary

Addresses

Primary practice location

25500 Rancho Niguel Rd Ste 110
Laguna Niguel, CA 92677-7373

Mailing address

24422 Avenida de la Carlota Ste 300
Laguna Hills, CA 92653-3628
Phone (949) 599-2423

Other practice location 1

4870 Barranca Pkwy
Suite 300
Irvine, CA 92604-4709
Phone (949) 791-3102

Other names 1

  • Dr. Jacqueline Dinoto Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130206000216 CA Practitioner - Pediatric Medicine 6709037930 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Mar 1, 2014 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Hoag Hospital Past Accepting new patients
Coastal Kids, a Professional Medical Corporation Pediatrics Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients

Locations

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

4900 Barranca Pkwy
Ste 103
Irvine, CA 92604
Phone (949) 726-0600

4870 Barranca Pkwy
Ste 300
Irvine, CA 92604
Phone (949) 552-9628

1401 Avocado Ave
Ste 303
Newport Beach, CA 92660
Phone (949) 717-0072

510 Superior Ave
Ste 200B
Newport Beach, CA 92663
Phone (800) 400-4624

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1629398490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24422 AVENIDA DE LA CARLOTA STE 300",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533628",
            "telephone_number": "949-599-2423",
            "fax_number": "949-599-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 RANCHO NIGUEL RD STE 110",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777373",
            "telephone_number": "949-448-8821",
            "fax_number": "949-448-8831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4870 Barranca Pkwy",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926044709",
            "country_code": "US",
            "telephone_number": "949-791-3102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A111658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "DINOTO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.