Individual provider Active NPI

Mary Jacena Siy Leigh, MD

  • Developmental - Behavioral Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1881882124
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
A101355 Issued in CA
Practice address
2825 50TH St
Sacramento, CA 95817-2310
Phone
(916) 703-0261
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A101355 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X A101355 CA Primary

Addresses

Primary practice location

2825 50TH St
Sacramento, CA 95817-2310

Mailing address

2825 50TH St
Sacramento, CA 95817-2310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20121119000299 CA Practitioner - Pediatric Medicine 0547411696 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Nov 1, 2012 Accepting new patients
Regents of the University of Ca Pediatrics CurrentSince Nov 1, 2012 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2825 50th St
Sacramento, CA 95817
Phone (916) 703-0300

Organizations & group practices 4

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1881882124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 50TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 50TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172310",
            "telephone_number": "916-703-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGH",
        "first_name": "MARY JACENA",
        "middle_name": "SIY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A101355",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "A101355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.