Individual provider Active NPI

Clinton J Leonard, MD

  • Obstetrics & Gynecology Physician
  • Gilbert, AZ
National Provider Identifier
1770575920
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
33779 Issued in AZ
Practice address
3499 S Mercy Rd
Gilbert, AZ 85297-0437
Phone
(480) 355-8525
Fax
(480) 355-3115
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 33779 AZ Primary

Addresses

Primary practice location

3499 S Mercy Rd
Gilbert, AZ 85297-0437

Mailing address

PO Box 756
Gilbert, AZ 85299-0756
Phone (480) 355-8525

Other identifiers 1

IdentifierTypeStateIssuer
942145MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050718000943 AZ Practitioner - Obstetrics/Gynecology 4082641493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Baylor College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morning Star Obstetrics and Gynecology PCGroup PAC ID 0648207043, 4 clinicians

Practice addresses (Care Compare)

3499 S Mercy Rd
Gilbert, AZ 85297-0437
Phone (480) 355-8525

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Morning Star Obstetrics & Gynecology PC Obstetrics & Gynecology CurrentSince Jul 1, 2005 Accepting new patients
Dignity Health Past Accepting new patients

Locations

3499 S Mercy Rd
Gilbert, AZ 85297
Phone (480) 355-8525

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1770575920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 756",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852990756",
            "telephone_number": "480-355-8525",
            "fax_number": "480-355-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3499 S MERCY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970437",
            "telephone_number": "480-355-8525",
            "fax_number": "480-355-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "CLINTON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "33779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942145",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.