Individual provider Active NPI

Carol Leong, AGACNP-BC

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1902293194
Registry record updated Apr 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP128034 Issued in TX
Practice address
302 Pearl Pkwy Apt 3210
San Antonio, TX 78215-1288
Phone
(917) 903-8731
NPI assigned
Apr 25, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP128034 TX Primary

Addresses

Primary practice location

302 Pearl Pkwy Apt 3210
San Antonio, TX 78215-1288

Mailing address

302 Pearl Pkwy Apt 3210
San Antonio, TX 78215-1288
Phone (917) 903-8731

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170501000544 NY Practitioner - Nurse Practitioner 5395046643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.79 of 100Reported as group
Quality
80.63
Improvement activities
40
Cost
49.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
464 Bay Ridge Medical PLLC CurrentSince Dec 1, 2022 Accepting new patients
Memorial Anesthesiology Group CurrentSince Mar 26, 2017 Accepting new patients

Locations

464 Bay Ridge Ave
Ste B
Brooklyn, NY 11220
Phone (347) 801-2542

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: cleong41982@mskcc.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429920000000",
    "number": "1902293194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PEARL PKWY APT 3210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151288",
            "telephone_number": "917-903-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PEARL PKWY APT 3210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151288",
            "telephone_number": "917-903-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONG",
        "first_name": "CAROL",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-25",
        "last_updated": "2015-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP128034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.