Active NPI
Sophia V Leonida, MD
- Pediatrics Physician
- Fairfield, CT
National Provider Identifier
1700821816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 023160
- Practice address
- 2228 Black Rock Tpke
Suite 211
Fairfield, CT 06825-3237 - Phone
- (203) 375-9350
- Fax
- (203) 375-8013
- NPI assigned
- Jun 20, 2006
- Last updated
- Mar 17, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 023160 | CT | Primary |
Addresses
Primary practice location
2228 Black Rock Tpke
Suite 211
Fairfield, CT 06825-3237
Mailing address
2228 Black Rock Tpke
Suite 211
Fairfield, CT 06825-3237
Phone (203) 375-9350
Other identifiers 18
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061152058 | Other | CT | MED SPAN |
| 7530584100 | Other | CT | CONNECTICARE |
| 01023160 | Other | CT | CIGNA HEALTH PLANS |
| 114485 | Other | CT | PREFERRED ONE |
| 114485 | Other | CT | YALE PREFERRED HEALTH |
| 00123160400 | Other | CT | BLUE CARE FAMILY PLAN |
| 010023160CT05 | Other | CT | BLUE CROSS BLUE SHIELD |
| 061152058 | Other | CT | HEALTH CARE VALUEMANAGMET |
| 061152058 | Other | CT | HEALTH SOURCE |
| 0040556 | Other | CT | U.S. HEALTH CARE |
| 061152058 | Other | CT | COMMERCIAL INSURANCE |
| 061152058 | Other | CT | HMO |
| 001231604 | Medicaid | CT | |
| 061152058 | Other | CT | UNITED HEALTH CARE |
| 061152058 | Other | CT | PHCS |
| 2173536 | Other | CT | AETNA |
| 061152058 | Other | CT | HEALTH CHOICE |
| ZP060 | Other | CT | OXFORD HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023160 | CT | MD | Pediatrics 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.
-
dba Stationhouse Pediatrics
- Primary Care Clinic/Center
- Stratford, CT
- NPI 1205958675
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426550400000",
"number": "1700821816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2228 BLACK ROCK TPKE",
"address_2": "SUITE 211",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068253237",
"telephone_number": "203-375-9350",
"fax_number": "203-375-8013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2228 BLACK ROCK TPKE",
"address_2": "SUITE 211",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068253237",
"telephone_number": "203-375-9350",
"fax_number": "203-375-8013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONIDA",
"first_name": "SOPHIA",
"middle_name": "V",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2015-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CT",
"license": "023160",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MED SPAN",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "7530584100",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLANS",
"identifier": "01023160",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "114485",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "YALE PREFERRED HEALTH",
"identifier": "114485",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE FAMILY PLAN",
"identifier": "00123160400",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "010023160CT05",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH CARE VALUEMANAGMET",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH SOURCE",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "U.S. HEALTH CARE",
"identifier": "0040556",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL INSURANCE",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO",
"identifier": "061152058",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001231604",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2173536",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH CHOICE",
"identifier": "061152058",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "ZP060",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.