Organization Active NPI

Polly E. Leonard, D.O., LTD

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1972746550
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
POLLY E. LEONARD, D.O., LTD
Practice address
390 Toll Gate Rd
Suite 203
Warwick, RI 02886-4326
Phone
(401) 732-2031
Fax
(888) 948-3254
NPI assigned
Apr 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Authorized official

Name
Dr. Polly Leonard, D.O.NPI 1801893367
Title
Owner/Doctor
Phone
(401) 732-2031

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204D00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

390 Toll Gate Rd
Suite 203
Warwick, RI 02886-4326

Mailing address

390 Toll Gate Rd Ste 203
Warwick, RI 02886-4326
Phone (401) 732-2031

Other identifiers 1

IdentifierTypeStateIssuer
9002762MedicaidRI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130109000481 RI Part B Supplier - Clinic/Group Practice 5799938346 Receives reassigned benefits from 1 practitioner
Practice locations: Warwick, RI

National Provider Directory

National Provider Directory

Locations

390 Toll Gate Rd
Ste 203
Warwick, RI 02886
Phone (401) 732-2031

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1972746550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD STE 203",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-732-2031",
            "fax_number": "888-948-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "SUITE 203",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-732-2031",
            "fax_number": "888-948-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLLY E. LEONARD, D.O., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "POLLY",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "401-732-2031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9002762",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.