Active NPI
Leon Michael Cattolico, D.O.
- Family Medicine Physician
- Flagstaff, AZ
National Provider Identifier
1720084197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3427
- Practice address
- 1200 N. Beaver
Payer Credentialing
Flagstaff, AZ 86001 - Phone
- (928) 213-6235
- Fax
- (928) 213-6292
- NPI assigned
- Jun 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS-3268-L | PA | |
| Family Medicine Physician | 207Q00000X | 3427 | AZ | Primary |
Addresses
Primary practice location
1200 N. Beaver
Payer Credentialing
Flagstaff, AZ 86001
Mailing address
450 S Willard St
Cottonwood, AZ 86326-6743
Phone (928) 634-5551
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 471467 | Medicaid | AZ | |
| 3427 | Other | AZ | LICENSE |
| AC-6555695 | Other | D.E.A. |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3427 | AZ | MD | Dentist |
| OS-3268-L | PA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Conemaugh Health Initiatives | Family Medicine | Past | Accepting new patients |
| Windber Hospital, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- New Paris, PA
- NPI 1487724597
-
- General Acute Care Hospital
- Windber, PA
- NPI 1275620536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1720084197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 S WILLARD ST",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863266743",
"telephone_number": "928-634-5551",
"fax_number": "928-634-5604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N. BEAVER",
"address_2": "PAYER CREDENTIALING",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86001",
"telephone_number": "928-213-6235",
"fax_number": "928-213-6292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CATTOLICO",
"first_name": "LEON",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-22",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OS-3268-L",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "3427",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "471467",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "3427",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "D.E.A.",
"identifier": "AC-6555695",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.