Physician Compare National (NPI:1306857909)

HEALTHCARE PROVIDER: JOSE DABU LEONCIO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306857909
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901060524
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120612000318
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEONCIO
	Individual professional last name
Provider First Name	JOSE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1970
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	736 BATTLEFIELD BLVD N
	Group Practice or individual's line 1 address
City	CHESAPEAKE
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	233204941
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7574855371
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490120
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHESAPEAKE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y