Individual provider Active NPI

Leon M Brostoff, MD

  • Pediatrics Physician
  • Monroeville, PA
National Provider Identifier
1992708846
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD028937E Issued in PA
Practice address
2790 Mosside Blvd
Ste 700
Monroeville, PA 15146-2758
Phone
(412) 380-9250
Fax
(412) 380-9253
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD028937E PA Primary

Addresses

Primary practice location

2790 Mosside Blvd
Ste 700
Monroeville, PA 15146-2758

Mailing address

11279 Perry Hwy
Ste 450
Wexford, PA 15090-9303
Phone (724) 933-1100

Other identifiers 1

IdentifierTypeStateIssuer
0010381790008MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160415001241 PA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7810295342

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD028937EPAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992708846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11279 PERRY HWY",
            "address_2": "STE 450",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909303",
            "telephone_number": "724-933-1100",
            "fax_number": "724-933-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 MOSSIDE BLVD",
            "address_2": "STE 700",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462758",
            "telephone_number": "412-380-9250",
            "fax_number": "412-380-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSTOFF",
        "first_name": "LEON",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD028937E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010381790008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.