Individual provider Active NPI

Marlen Leon, MD

  • Ophthalmology Physician
  • Lakeland, FL
National Provider Identifier
1699935320
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME115732 Issued in FL
Practice address
4708 S Florida Ave
Lakeland, FL 33813-2165
Phone
(863) 858-2020
NPI assigned
Jun 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 067673 GA
Ophthalmology Physician 207W00000X ME115732 FL Primary

Addresses

Primary practice location

4708 S Florida Ave
Lakeland, FL 33813-2165

Mailing address

4708 S Florida Ave
Lakeland, FL 33813-2165
Phone (305) 878-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120813000720 GA Practitioner - Ophthalmology 8123274842 Reassigns benefits to 2 organizations
I20131105001822 FL Practitioner - Ophthalmology 8123274842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Physicians of Pinellas, PAGroup PAC ID 5092629071, 39 clinicians

Practice addresses (Care Compare)

1243 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Phone (863) 262-3111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME115732FLMDOphthalmology Physician
067673GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Ophthalmology CurrentSince Jul 1, 1966 Accepting new patients
The Eye Physicians of Pinellas, PA CurrentSince Feb 1, 2023 Accepting new patients
The Emory Clinic Inc CurrentSince Jul 7, 2012 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
The Eye Physicians of Pinellas, PA Ophthalmology CurrentSince Feb 1, 2023 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Jul 1, 1966 Accepting new patients
The Eye Physicians of Pinellas, PA Past Accepting new patients

Locations

4708 S Florida Ave
Lakeland, FL 33813
Phone (863) 644-6455

1243 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 262-3111

1247 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 688-5604

148 13th St SW
Largo, FL 33770
Phone (727) 450-3030

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: marlen.leon.1@18417.direct.athenahealth.com

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1699935320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132165",
            "telephone_number": "305-878-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4708 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132165",
            "telephone_number": "863-858-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "MARLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "067673",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME115732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.