Individual provider Active NPI

Leonard J McIntyre, M.D.

  • Psychiatry Physician
  • Mesa, AZ
National Provider Identifier
1720158892
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
27994 Issued in AZ
Practice address
1440 S Country Club Dr
#12
Mesa, AZ 85210-9701
Phone
(480) 838-5550
Fax
(480) 756-8201
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 27994 AZ Primary

Addresses

Primary practice location

1440 S Country Club Dr
#12
Mesa, AZ 85210-9701

Mailing address

2700 N Central Ave
1050
Phoenix, AZ 85004-1133
Phone (602) 266-8402

Other identifiers 1

IdentifierTypeStateIssuer
879455MedicaidAZ

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 Medicine

State licenses

LicenseStateTypeSpecialty
27994AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vo of Arizona, Inc. Past Accepting new patients
Magellan Health Services of Arizona, 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1720158892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 N CENTRAL AVE",
            "address_2": "1050",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041133",
            "telephone_number": "602-266-8402",
            "fax_number": "602-264-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 S COUNTRY CLUB DR",
            "address_2": "#12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852109701",
            "telephone_number": "480-838-5550",
            "fax_number": "480-756-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "LEONARD",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "27994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "879455",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.