Individual provider Active NPI

Marshall Leonard, MD

  • Emergency Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1902255318
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
298264 Issued in NY
Practice address
100 Nicolls Rd, HSC, L4 RM 50
Stony Brook, NY 11794-0001
Phone
(631) 444-2478
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 298264 NY Primary

Addresses

Primary practice location

100 Nicolls Rd, HSC, L4 RM 50
Stony Brook, NY 11794-0001

Mailing address

Department of Emergency Medicine
100 Nicolls Rd. HSC, L-4, RM 050
Stony Brook, NY 11794
Phone (631) 444-2478

Other practice location 1

Stony Brook Medicine
Department of Emergency Medicine, HSC Level 4 Room 080
Stony Brook, NY 11794-8350
Phone (631) 444-3880

Other practice location 2

Department of Emergency Medicine
300 Community Dr.
Manhasset, NY 11030
Phone (516) 562-1238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200511000798 NY Practitioner - Emergency Medicine 9436580370 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Mar 1, 2020 Accepting new patients
Stony Brook Emergency Physicians, University Faculty Practice Corporat Emergency Medicine CurrentSince Apr 22, 2020 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 1, 2020 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Plandome, NY 11030

1 Heroes Way
Riverhead, NY 11901
Phone (631) 548-6000

100 Nicolls Rd
Rm 50
Stony Brook, NY 11794

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: marshall.leonard@direct.stonybrookmedicine.edu

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": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1902255318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF EMERGENCY MEDICINE",
            "address_2": "100 NICOLLS RD. HSC, L-4, RM 050",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD, HSC, L4 RM 50",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook Medicine",
            "address_2": "Department of Emergency Medicine, HSC Level 4 Room 080",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948350",
            "country_code": "US",
            "telephone_number": "631-444-3880",
            "fax_number": "631-444-3919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Department of Emergency Medicine",
            "address_2": "300 Community Dr.",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "11030",
            "country_code": "US",
            "telephone_number": "516-562-1238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "MARSHALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "298264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.