Individual provider Active NPI

Leonard Anderson, MD

  • Vascular Surgery Physician
  • Johnson City, NY
National Provider Identifier
1760482863
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
192394 Issued in NY
Practice address
30 Harrison St
Suite 455
Johnson City, NY 13790-2161
Phone
(607) 763-8100
Fax
(607) 763-8048
NPI assigned
Jul 29, 2005
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 192394 NY Primary

Addresses

Primary practice location

30 Harrison St
Suite 455
Johnson City, NY 13790-2161

Mailing address

346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 729-8156

Other identifiers 1

IdentifierTypeStateIssuer
01415796MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100107000025 NY Practitioner - Vascular Surgery 9537200993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Temple University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Harrison St
Johnson City, NY 13790-2161
Phone (607) 763-8101

33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101

54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Varicose vein removal1-10
Leg revascularization (restoring blood flow)21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Health Services Hospitals, Inc. CurrentSince Dec 18, 2011 Accepting new patients
United Health Services Hospitals, Inc. Past Accepting new patients

Locations

33 Lewis Rd
Binghamton, NY 13905
Phone (607) 240-2545

30 Harrison St
Ste 455
Johnson City, NY 13790
Phone (607) 763-8100

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

Interoperability endpoints

  • FHIR API: https://epicproxy.et1127.epichosted.com/FHIRproxy/api/FHIR/R4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1760482863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902580",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HARRISON ST",
            "address_2": "SUITE 455",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902161",
            "telephone_number": "607-763-8100",
            "fax_number": "607-763-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LEONARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "192394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01415796",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.