Organization Active NPI

Leon a Cohen, M.D. PA

  • Specialist
  • Merritt Island, FL
National Provider Identifier
1851663348
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME50207 Issued in FL
Legal business name
LEON A COHEN, M.D. PA
Practice address
375 S Courtenay Pkwy
Suite 1
Merritt Island, FL 32952-4868
Phone
(321) 453-3420
Fax
(321) 453-8262
NPI assigned
Jan 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Authorized official

Name
Dr. Leon Alan Cohen, M.D.NPI 1558329607
Title
President/Medical Doctor
Phone
(321) 453-3420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME50207 FL Primary

Addresses

Primary practice location

375 S Courtenay Pkwy
Suite 1
Merritt Island, FL 32952-4868

Mailing address

375 S Courtenay Pkwy
Suite 1
Merritt Island, FL 32952-4868
Phone (321) 453-3420

Other identifiers 1

IdentifierTypeStateIssuer
046926200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120203000067 FL Part B Supplier - Clinic/Group Practice 1254598204 Receives reassigned benefits from 1 practitioner
Practice locations: Cocoa Beach, FL; Merritt Island, FL; Rocklegde, FL

National Provider Directory

National Provider Directory

Locations

375 S Courtenay Pkwy
Ste 1
Merritt Island, FL 32952
Phone (321) 453-3420

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1851663348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S COURTENAY PKWY",
            "address_2": "SUITE 1",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524868",
            "telephone_number": "321-453-3420",
            "fax_number": "321-453-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S COURTENAY PKWY",
            "address_2": "SUITE 1",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524868",
            "telephone_number": "321-453-3420",
            "fax_number": "321-453-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEON A COHEN, M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DOCTOR",
        "authorized_official_telephone_number": "321-453-3420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME50207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046926200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.