Individual provider Active NPI

Jacob Beck Leary, MD

  • Hematology & Oncology Physician
  • La Jolla, CA
National Provider Identifier
1932777125
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A201344 Issued in CA
Practice address
3855 Health Sciences Drive
#0829
La Jolla, CA 92093-0829
Phone
(858) 657-5281
Fax
(858) 657-5348
NPI assigned
Jun 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X A201344 CA Primary

Addresses

Primary practice location

3855 Health Sciences Drive
#0829
La Jolla, CA 92093-0829

Mailing address

3855 Health Sciences Drive #0829
La Jolla, CA 92093-0829
Phone (858) 657-5281

Other identifiers 1

IdentifierTypeStateIssuer
A201344OtherCAMEDICAL LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220427002719 WA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0042607731

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A201344CAMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1932777125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DRIVE #0829",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930829",
            "telephone_number": "858-657-5281",
            "fax_number": "858-657-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DRIVE",
            "address_2": "#0829",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930829",
            "telephone_number": "858-657-5281",
            "fax_number": "858-657-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "JACOB",
        "middle_name": "BECK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A201344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "A201344",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.