Individual provider Active NPI

Maria del Carmen Leon, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1922206390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
010148-01 Issued in NY
Practice address
111 E 210TH St
Bronx, NY 10467-2401
Phone
(718) 920-2985
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 010148-01 NY Primary

Addresses

Primary practice location

111 E 210TH St
Bronx, NY 10467-2401

Mailing address

527 Wantagh Ave
Wantagh, NY 11793-2102
Phone (631) 871-4240

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
I20240821003318 NY Practitioner - Physician Assistant 3870031842 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
010148-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC CurrentSince Jun 6, 2024 Accepting new patients
CHS Physician Partners, P.C CurrentSince Jun 6, 2024 Accepting new patients
Montefiorre Medical Center Physician Assistant Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

Interoperability endpoints

  • Direct secure messaging: mrd9260@direct.nyp.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922206390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932102",
            "telephone_number": "631-871-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "MARIA DEL CARMEN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010148-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.