Individual provider Active NPI

Danielle M. Leblanc, M.D.

  • Plastic Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1669439790
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
M0787 Issued in TX
Practice address
800 8TH Ave
Suite 406
Fort Worth, TX 76104-2601
Phone
(817) 698-9990
Fax
(817) 698-9997
NPI assigned
May 1, 2006
Last updated
May 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X M0787 TX Primary

Addresses

Primary practice location

800 8TH Ave
Suite 406
Fort Worth, TX 76104-2601

Mailing address

800 8TH Ave
Suite 406
Fort Worth, TX 76104-2601
Phone (817) 698-9990

Other identifiers 3

IdentifierTypeStateIssuer
7760708OtherTXAETNA
0016NBOtherTXBCBS
177164401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050927000379 TX Practitioner - Plastic and Reconstructive Surgery 6709810971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 8TH Ave
Suite 406
Fort Worth, TX 76104-2618
Phone (817) 698-9990

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0787TXMDPlastic Surgery Physician

Organizations & group practices 1

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1669439790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 8TH AVE",
            "address_2": "SUITE 406",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042601",
            "telephone_number": "817-698-9990",
            "fax_number": "817-698-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 8TH AVE",
            "address_2": "SUITE 406",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042601",
            "telephone_number": "817-698-9990",
            "fax_number": "817-698-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "DANIELLE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "M0787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7760708",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0016NB",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177164401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.