Individual provider Active NPI

Leon Rawner, M.D.

  • General Practice Physician
  • Hallandale Beach, FL
National Provider Identifier
1700105616
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
120366 Issued in FL
Practice address
2500 E Hallandale Beach Blvd Ste 301
Hallandale Beach, FL 33009-4835
Phone
(954) 458-2572
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 120366 FL Primary

Addresses

Primary practice location

2500 E Hallandale Beach Blvd Ste 301
Hallandale Beach, FL 33009-4835

Mailing address

5355 Lyons Rd
Coconut Creek, FL 33073
Phone (954) 570-9595

Other identifiers 1

IdentifierTypeStateIssuer
012907800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150114001256 FL Practitioner - General Practice 9234312273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Complete Local Specialty Care IncGroup PAC ID 3971591231, 29 clinicians

Practice addresses (Care Compare)

2500 E Hallandale Beach Blvd
Suite 301
Hallandale Beach, FL 33009-4835
Phone (954) 458-2572

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Mount Sinai Medical Center of Florida, Inc Hospital, Miami Beach, FL, CCN 100034

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
120366FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Local Specialty Care, Inc CurrentSince Oct 5, 2015 Accepting new patients
Mel-Bay Health Care Inc PastSince Oct 5, 2015 Accepting new patients
Complete Local Specialty Care, Inc. PastSince Jun 6, 2021 Accepting new patients
Complete Local Specialty Care, Inc Past Accepting new patients

Locations

950 Glades Rd
Ste 4A
Boca Raton, FL 33431
Phone (561) 391-8086

5355 Lyons Rd
Coconut Creek, FL 33073
Phone (954) 570-9595

4855 W Hillsboro Blvd
Ste B2
Coconut Creek, FL 33073
Phone (954) 418-1683

2500 E Hallandale Beach Blvd
Ste 301
Hallandale Beach, FL 33009
Phone (954) 458-2572

1770 E Hallandale Beach Blvd
Ste 301
Hallandale Beach, FL 33009
Phone (954) 458-2572

3850 Hollywood Blvd
Ste 203
Hollywood, FL 33021
Phone (954) 442-1133

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJGBDA
  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEGBA

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1700105616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5355 LYONS RD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "33073",
            "telephone_number": "954-570-9595",
            "fax_number": "954-354-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 301",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094835",
            "telephone_number": "954-458-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWNER",
        "first_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "120366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012907800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

Verify at the official NPI Registry.