Individual provider Active NPI

Baoan Gia Le, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1649350034
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36389 Issued in AZ
Practice address
4527 N 27TH Ave
Phoenix, AZ 85017-3702
Phone
(602) 249-4508
Fax
(602) 249-1614
NPI assigned
Oct 17, 2006
Last updated
Apr 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 94404 FL
Family Medicine Physician 207Q00000X 23089 OK
Family Medicine Physician 207Q00000X 36389 AZ Primary

Addresses

Primary practice location

4527 N 27TH Ave
Phoenix, AZ 85017-3702

Mailing address

2325 E Shea Blvd
Phoenix, AZ 85028-3115
Phone (918) 344-0130

Other names 1

  • Andy Gia Le Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20070329000441 AZ Practitioner - Geriatric MedicinePractitioner - Family Practice 9739169590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epangelia Properties, LLCGroup PAC ID 5799838140, 4 clinicians

Practice addresses (Care Compare)

1847 W Heatherbrae Dr
Phoenix, AZ 85015-4764
Phone (602) 274-2100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 94404FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizna Medical Clinic LLC Family Medicine Current Accepting new patients
Epangelia Properties, LLC Family Medicine CurrentSince Jun 1, 2009 Accepting new patients
Arizona Medical Clinic Thomas Rd, LLC Family Medicine PastSince Feb 18, 2024 Accepting new patients

Locations

761 E University Dr
Ste C
Mesa, AZ 85203

1847 W Heatherbrae Dr
Phoenix, AZ 85015
Phone (602) 249-4508

1847 W Heatherbrae Dr
Ste A
Phoenix, AZ 85015
Phone (602) 263-0663

4527 N 27th Ave
Phoenix, AZ 85017
Phone (602) 249-4508

5140 E Thomas Rd
Phoenix, AZ 85018
Phone (602) 207-8400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1649350034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 E SHEA BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283115",
            "telephone_number": "918-344-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4527 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850173702",
            "telephone_number": "602-249-4508",
            "fax_number": "602-249-1614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "BAOAN",
        "middle_name": "GIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 94404",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "23089",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "LE",
            "middle_name": "GIA",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.