Individual provider Active NPI

Petros Gene Leinonen, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Oak Ridge, TN
National Provider Identifier
1891765848
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
56986 Issued in TN
Practice address
988 Oak Ridge Tpke Ste 380
Oak Ridge, TN 37830
Phone
(865) 481-0183
Fax
(865) 481-0186
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD22537 OR
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X R0057 TX
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 56986 TN Primary

Addresses

Primary practice location

988 Oak Ridge Tpke Ste 380
Oak Ridge, TN 37830

Mailing address

988 Oak Ridge Tpke Ste 380
Oak Ridge, TN 37830-6998
Phone (865) 481-0183

Other practice location 1

3851 Roger Brooke Dr
Brooke Army Medical Center MCHE-QD(Creds)
Fort Sam Houston, TX 78234-4501
Phone (210) 916-2412

Other identifiers 1

IdentifierTypeStateIssuer
Q035750MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20180620001922 TN Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 1557683224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
East Tennessee Cardiovascular Surgery Group PCGroup PAC ID 6608934203, 20 clinicians

Practice addresses (Care Compare)

9125 Cross Park Dr
Suite 200
Knoxville, TN 37923-4563
Phone (865) 632-5900

988 Oak Ridge Tpke
Suite 380
Oak Ridge, TN 37830-6998
Phone (865) 481-0183

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56986TNMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
R0057TXMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Cardiovascular Surgery Group, P.C Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 15, 2018 Accepting new patients

Locations

9330 Park West Blvd
Ste 100
Knoxville, TN 37923
Phone (865) 373-7942

9125 Cross Park Dr
Ste 200
Knoxville, TN 37923
Phone (865) 632-5900

Dept 888101
Knoxville, TN 37995

988 Oak Ridge Tpke
Ste 380
Oak Ridge, TN 37830
Phone (865) 481-0183

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1891765848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE 380",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306998",
            "telephone_number": "865-481-0183",
            "fax_number": "865-481-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 OAK RIDGE TPKE STE 380",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-481-0183",
            "fax_number": "865-481-0186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3851 Roger Brooke Dr",
            "address_2": "Brooke Army Medical Center MCHE-QD(Creds)",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344501",
            "country_code": "US",
            "telephone_number": "210-916-2412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEINONEN",
        "first_name": "PETROS",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OR",
            "license": "MD22537",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "R0057",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TN",
            "license": "56986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q035750",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.