Individual provider Active NPI

Leslie Fujiko Shigemasa, R.D.

  • Registered Dietitian
  • Santa Ana, CA
National Provider Identifier
1932231792
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
00709620 Issued in CA
Practice address
2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873
Phone
(714) 628-3242
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 00709620 CA Primary

Addresses

Primary practice location

2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873

Mailing address

2212 E 4TH St Ste 301
Santa Ana, CA 92705-3873
Phone (714) 628-3242

Other identifiers 2

IdentifierTypeStateIssuer
709620OtherCADIETETIC REGISTRATION
0901-8202OtherCACERTIFIED DIABETES ED.

Other names 1

  • Leslie F. Honda Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151230000410 CA Practitioner - Registered Dietitian Or Nutrition Professional 3779885280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00709620CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Oct 7, 2022 Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

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.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1932231792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 301",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053873",
            "telephone_number": "714-628-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 E 4TH ST STE 301",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053873",
            "telephone_number": "714-628-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIGEMASA",
        "first_name": "LESLIE",
        "middle_name": "FUJIKO",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "00709620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIETETIC REGISTRATION",
            "identifier": "709620",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIABETES ED.",
            "identifier": "0901-8202",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "HONDA",
            "middle_name": "F.",
            "credential": "RD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.