Individual provider Active NPI

Trey Henry Leaven, M.D., M.S.

  • Family Medicine Physician
  • Sanford, FL
National Provider Identifier
1851619183
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME131955 Issued in FL
Practice address
4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone
(407) 322-8645
NPI assigned
May 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 0101240932 VA
Family Medicine Physician 207Q00000X ME131955 FL Primary

Addresses

Primary practice location

4930 E Lake Mary Blvd
Sanford, FL 32771-5003

Mailing address

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone (407) 322-8645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231025004058 FL Practitioner - Family Practice 3870742307

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Family Health Center, IncGroup PAC ID 3870519234, shared by 13 NPIs, 17 clinicians

Practice addresses (Care Compare)

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone 40732286452011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME131955FLMDFamily Medicine Physician
0101240932VAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Family Health Center, Inc. Past Accepting new patients
Central Florida Family Health Center, Inc. Past Accepting new patients

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": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1851619183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVEN",
        "first_name": "TREY",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-11",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0101240932",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME131955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

Verify at the official NPI Registry.