Individual provider Active NPI

Fermin Leguen, MD

  • Public Health & General Preventive Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1740330711
Registry record updated Jul 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
ME79753 Issued in FL
Practice address
280 S Decatur Blvd
Las Vegas, NV 89107
Phone
(702) 759-1000
Fax
(702) 759-1478
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME79753 FL
Public Health & General Preventive Medicine Physician 2083P0901X ME79753 FL Primary

Addresses

Primary practice location

280 S Decatur Blvd
Las Vegas, NV 89107

Mailing address

7551 Forest Oaks Blvd
Spring Hill, FL 34606
Phone (352) 540-6800

Other identifiers 1

IdentifierTypeStateIssuer
258349600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20200317000224 NV Practitioner - Preventive MedicinePractitioner - General Practice 5890766208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME79753FLMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: fermin.leguen@snhd.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southern Neveda Community Health CenterLas Vegas, NV, CCN 291867 Federally qualified health center Corporate Director (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Aug 1, 2016
Aug 1, 2016
Jan 10, 2020
Southern Nevada Community Health CenterLas Vegas, NV, CCN 291007 Federally qualified health center Contracted Managing Employee
Corporate Officer
Aug 1, 2016
Aug 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1740330711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7551 FOREST OAKS BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "34606",
            "telephone_number": "352-540-6800",
            "fax_number": "352-688-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89107",
            "telephone_number": "702-759-1000",
            "fax_number": "702-759-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGUEN",
        "first_name": "FERMIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME79753",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "FL",
            "license": "ME79753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258349600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.