Individual provider Active NPI

Leydis Cantillo

  • Family Nurse Practitioner
  • Bonita Springs, FL
National Provider Identifier
1922632934
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11006215 Issued in FL
Practice address
3302 Bonita Beach Rd Ste 170
Bonita Springs, FL 34134-4217
Phone
(239) 624-1050
Fax
(239) 624-1051
NPI assigned
Feb 28, 2020
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11006215 FL Primary

Addresses

Primary practice location

3302 Bonita Beach Rd Ste 170
Bonita Springs, FL 34134-4217

Mailing address

310 29TH St SW
Naples, FL 34117-3125
Phone (305) 764-5764

Other practice location 1

851 5th Ave N Ste 102
Naples, FL 34102-5582
Phone (239) 315-7801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211221000160 FL Practitioner - Nurse Practitioner 9638560907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

3302 Bonita Beach Rd
Suite 170
Bonita Springs, FL 34134-4217
Phone (239) 992-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.25 of 100Reported as apm
Quality
87.73
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11006215FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Sep 5, 2024 Accepting new patients
Nchmd Inc CurrentSince Sep 5, 2024 Accepting new patients

Locations

3302 Bonita Beach Rd
Ste 170
Bonita Springs, FL 34134
Phone (239) 624-1050

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lcantillo86603@nchhealthcaresystem.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1922632934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 29TH ST SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341173125",
            "telephone_number": "305-764-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 BONITA BEACH RD STE 170",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341344217",
            "telephone_number": "239-624-1050",
            "fax_number": "239-624-1051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 5th Ave N Ste 102",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025582",
            "country_code": "US",
            "telephone_number": "239-315-7801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTILLO",
        "first_name": "LEYDIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11006215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.