Individual provider Active NPI

Benjamin Russell Leavy, M.D.

  • Family Medicine Physician
  • Sacramento, CA
National Provider Identifier
1710960307
Registry record updated Aug 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A070315 Issued in CA
Practice address
500 University Ave
Suite 220
Sacramento, CA 95825-6504
Phone
(916) 286-8700
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A070315 CA Primary

Addresses

Primary practice location

500 University Ave
Suite 220
Sacramento, CA 95825-6504

Mailing address

500 University Ave
Suite 220
Sacramento, CA 95825-6504
Phone (916) 286-8700

Other identifiers 1

IdentifierTypeStateIssuer
00A703150MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081016000532 CA Practitioner - Family Practice 3870651003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

500 University Ave
Suite 220
Sacramento, CA 95825-6525
Phone (916) 286-8700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A070315CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince May 15, 2012 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince May 15, 2012 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

3111 Professional Dr
Auburn, CA 95603
Phone (530) 274-9762

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

3201 Data Dr
Rncho Cordova, CA 95670
Phone (916) 851-1424

3160 Folsom Blvd
Ste 1400
Sacramento, CA 95816
Phone (916) 731-1831

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

3160 Folsom Blvd
Ste 2500
Sacramento, CA 95816
Phone (916) 734-5846

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

Organizations & group practices 5

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1710960307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY AVE",
            "address_2": "SUITE 220",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256504",
            "telephone_number": "916-286-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY AVE",
            "address_2": "SUITE 220",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958256504",
            "telephone_number": "916-286-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVY",
        "first_name": "BENJAMIN",
        "middle_name": "RUSSELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A070315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A703150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.