Individual provider Active NPI

Patricia Diaz de Leon, P.A.

  • Physician Assistant
  • Corpus Christi, TX
National Provider Identifier
1821403056
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05954 Issued in TX
Practice address
7326 S Staples St
Corpus Christi, TX 78413-5509
Phone
(361) 993-0188
Fax
(361) 993-0240
NPI assigned
Jun 26, 2014
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05954 TX Primary
Medical Physician Assistant 363AM0700X PA05954 TX

Addresses

Primary practice location

7326 S Staples St
Corpus Christi, TX 78413-5509

Mailing address

12410 Toepperwein Rd
Live Oak, TX 78233-3230
Phone (210) 742-6555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160902000860 TX Practitioner - Physician Assistant 8123314911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hillside Primary Care PLLCGroup PAC ID 0648530386, 49 clinicians

Practice addresses (Care Compare)

12410 Toepperwein Rd
Live Oak, TX 78233-3230

4926 Golden Quail
Suite 104
San Antonio, TX 78240-1767
Phone (210) 742-6555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05954TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Heal Well Primary Care PC CurrentSince Mar 26, 2023 Accepting new patients

Locations

12410 Toepperwein Rd
Live Oak, TX 78233
Phone (210) 659-4425

12410 Toepperwein Rd
#O
Live Oak, TX 78233
Phone (210) 659-4425

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.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1821403056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333230",
            "telephone_number": "210-742-6555",
            "fax_number": "224-623-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7326 S STAPLES ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784135509",
            "telephone_number": "361-993-0188",
            "fax_number": "361-993-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ DE LEON",
        "first_name": "PATRICIA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05954",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.