Leslie M Brocchini, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A72362 Issued in CA

Practice address

19933 Greenley Rd Ste B
Sonora, CA 95370-5906

Phone

(209) 743-4249

Fax

(209) 536-0506

NPI assigned

Mar 17, 2006

Last updated

Dec 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Leslie Cooper Brocchini Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 1, 2015 through Sep 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1811966047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19933 GREENLEY RD STE B",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705906",
            "telephone_number": "209-743-4249",
            "fax_number": "209-536-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19933 GREENLEY RD STE B",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705906",
            "telephone_number": "209-743-4249",
            "fax_number": "209-536-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCCHINI",
        "first_name": "LESLIE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A72362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A723620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "BROCCHINI",
            "middle_name": "COOPER",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Emily Branscum, PHD
• Karen A Brasesco, P.T.
• Brett C Lockman DO Medical Corporation (Sierra Biotensegrity)
• Barbara Laura Briner
• Dan Briseno
• Melody Anne Brotby, M.A.
• Lawrence Eugene Brunel, M.D. F.A.C.O.G.
• John Michael Brunolli, PT
• Robert Charles Bunce, RADT
• Alexsis Grace Byers, ASW

• Internal Medicine Physician in Sonora, CA
• Providers in Sonora, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.