Leroy Moreno PA-C PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LEROY MORENO PA-C PLLC

Doing business as

Legacy Medical Clinic

Practice address

1506 S Lone Star Way Ste 7
Edinburg, TX 78539-4977

Phone

(956) 348-2918

Fax

(956) 348-2927

NPI assigned

Jun 23, 2023

Organization subpart

No

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

Authorized official

Name

Leroy Moreno, PANPI 1861863243

Title

Owner

Phone

(956) 648-5011

Specialties & licenses 2

Addresses

Other names 1

• LEGACY MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leroy Moreno

  • Medical Physician Assistant
  • Edinburg, TX
  • NPI 1861863243
  Medicare reassignment Care Compare group Authorized official
• Donna G Joule, MD

  • Family Medicine Physician
  • McAllen, TX
  • NPI 1407888753
  Medicare reassignment Care Compare group NPD
• Carlos R Vela

  • Physician Assistant
  • Edinburg, TX
  • NPI 1780302919
  Medicare reassignment Care Compare group NPD
• Julianna Luera, PA-C

  • Physician Assistant
  • Edinburg, TX
  • NPI 1447738091
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1932885126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 LONESTAR PLAZA WAY STE 7",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "78539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 S LONE STAR WAY STE 7",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785394977",
            "telephone_number": "956-348-2918",
            "fax_number": "956-348-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEROY MORENO PA-C PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "LEROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-648-5011",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEGACY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEGACY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Imre Lenar
• Carina Laritsa Leos, MS, LPC
• Cristina Lerma
• Kayla Monic Lerma, MS, LPC
• Diana Lerman, LVN
• Ryan Leslie, PHARM D.
• Lester W Peacock MD PA
• Letreise D. Winkfield, M.D., P.a.
• Lyuba Levine, MD
• Matthew A Levine, LCDC

• Family Medicine Physician in Edinburg, TX
• Providers in Edinburg, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.