Individual provider Active NPI

Leonard Penacerrada, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1649362310
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
236046 Issued in NY
Practice address
560 1St Ave
New York, NY 10016-6402
Phone
(212) 434-3040
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 236046 NY Primary

Addresses

Primary practice location

560 1St Ave
New York, NY 10016-6402

Mailing address

560 1St Ave
New York, NY 10016-6402

Other identifiers 1

IdentifierTypeStateIssuer
02666228MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lpenacerrada37035@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051114000040 NY Practitioner - Emergency Medicine 1355360934 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Current Accepting new patients
New York University Emergency Medicine CurrentSince Apr 22, 2012 Accepting new patients
New York University Emergency Medicine CurrentSince Dec 1, 2012 Accepting new patients
New York University CurrentSince Apr 22, 2012 Accepting new patients
Fpa Hospital Based CurrentSince Aug 1, 2014 Accepting new patients
New York University Emergency Medicine Current Accepting new patients
Fpa Hospital Based Emergency Medicine CurrentSince Aug 1, 2014 Accepting new patients
St. Vincent'S Emergency Services PC Emergency Medicine Past Accepting new patients
Park Lenox Emergency Medicine, PC Emergency Medicine Past Accepting new patients
Beth Israel Medical Center Emergency Medicine Past Accepting new patients
KHH Emergency Medicine Emergency Medicine Past Accepting new patients
LH Emergency Medical Services PC Emergency Medicine Past Accepting new patients

Locations

3201 Kings Hwy
Brooklyn, NY 11234
Phone (718) 252-3000

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

560 1st Ave
New York, NY 10016
Phone (212) 263-5362

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: lpenacerrada37035@nyumc.direct-ci.com

Organizations & group practices 12

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1649362310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-434-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENACERRADA",
        "first_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "236046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02666228",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lpenacerrada37035@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "560 1st Ave",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100166402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.