Kelley De Leeuw, M.D. M.P.H.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A114857 Issued in CA

Practice address

3350 La Jolla Village Dr
Dept of Psychiatry - 116a
San Diego, CA 92161-0002

Phone

(858) 552-8585

NPI assigned

Sep 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family PracticeAlso: Psychiatry

Education

Ponce School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centro de Salud de la Comunidad de San Ysidro,Inc.Group PAC ID 6901709435, 291 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kdeleeuw18314@syhealth.direct-ci.com

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.

• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Precision Park

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  Medicare reassignment Care Compare group NPD
• Centro de Salud de la Comunidad de San Ysidro Inc

  dba San Ysidro Health Senior Dental Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health El Cajon/San Diego PACE

  • Federally Qualified Health Center (FQHC)
  • El Cajon, CA
  • NPI 1568845741
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health National City

  • Federally Qualified Health Center (FQHC)
  • National City, CA
  • NPI 1003869363
  NPD (past)

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1720395361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "DEPT OF PSYCHIATRY - 116A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "address_2": "DEPT OF PSYCHIATRY - 116A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEEUW",
        "first_name": "KELLEY",
        "name_prefix": "Dr.",
        "credential": "M.D. M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A114857",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A114857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesus Ernesto De la Vega Jr.
• Luis De la Vega
• Natalie De la Vega
• Jennifer Michelle De Lago
• Marjorie L De Las Alas, OTR
• Shella Michelle De Leon Carizon
• Lizett B De Leon Johal, CRNA
• Victor Amaury De Leon-Hernandez, MD
• David Carmelo Ortiz De Leon, P.T.
• Dereck J. De Leon, MD

• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.