Leonardo Enrique Diez Perez

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11027991 Issued in FL

Practice address

858 Monument Rd # P
Jacksonville, FL 32225-6670

Phone

(904) 450-8060

NPI assigned

Aug 14, 2023

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent's Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent's Riverside Hospital, Jacksonville, FL, CCN 100040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leonardo.diez.perez.1@8967.direct.athenahealth.com

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment Care Compare group NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes - St Vincents Healthcare

  dba Ascension St. Vincent's Southside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747
  Care Compare affiliation
• St Vincents Medical Center Inc

  dba Ascension St. Vincent's Riverside

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575
  Care Compare affiliation
• St. Vincent's Medical Center, Inc.

  dba Ascension St Vincent's Riverside

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1861275984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 SAINT JOHNS BLUFF RD S APT 322",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242666",
            "telephone_number": "786-580-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "858 MONUMENT RD # P",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256670",
            "telephone_number": "904-450-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEZ PEREZ",
        "first_name": "LEONARDO",
        "middle_name": "ENRIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11027991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Dietlein
• Lacey Leigh Dietrich, ARNP
• William G Dietrich, MD
• Kaitlyn Dietz, RDN, LDN
• Harold Paul Dietzius, MD
• Maria Teresa Difato, L.C.S.W.
• Rachel Danielle Diffenbaugh
• Different Storks LLC
• Sharon Difino
• Olivia Difrank

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.