Individual provider Active NPI

Seraphine Leunkam, RN

  • Student in an Organized Health Care Education/Training Program
  • Largo, MD
National Provider Identifier
1740592989
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
901 Harry S Truman Dr N
Largo, MD 20774-5477
Phone
(240) 677-1000
NPI assigned
Jul 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X R147780 MD
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

901 Harry S Truman Dr N
Largo, MD 20774-5477

Mailing address

901 Harry S Truman Dr N
Largo, MD 20774-5477
Phone (240) 677-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110209001044 DC Practitioner - Nurse Practitioner 2365622255 Reassigns benefits to 1 organization
I20190722000078 MD Practitioner - Nurse Practitioner 2365622255 Reassigns benefits to 1 organization
I20241112001467 CA Practitioner - Internal Medicine 2365622255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R147780MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group Current Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Apr 22, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Apr 22, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 9, 2024 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 9, 2024 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

901 Harry S Truman Dr N
Uppr Marlboro, MD 20774
Phone (240) 677-0021

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

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.

NPI Registry JSON

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

{
    "created_epoch": "1278115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1740592989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-677-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HARRY S TRUMAN DR N",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745477",
            "telephone_number": "240-677-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNKAM",
        "first_name": "SERAPHINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-03",
        "last_updated": "2024-10-25",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R147780",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

Verify at the official NPI Registry.