DEIRDRE LEAKE MD NPI 1073617585

NPI Information

  • NPI: 1073617585
  • Provider Name: DEIRDRE LEAKE, MD
  • Classification: Otolaryngology - 207YS0123X
  • Specialization: Facial Plastic Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1750 TREE BLVD
    SUITE 10
    ST AUGUSTINE, FL
    ZIP 32084
  • Phone: (904) 810-5434

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NPI Details

Deirdre Leake, MD is a facial plastic surgery otolaryngology in St Augustine, FL with 28 years of experience. The provider is an otolaryngologist who specializes in facial plastic surgery. Deirdre Leake, MD NPI is 1073617585. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:1998

The provider's business location address is:

1750 TREE BLVD
SUITE 10
ST AUGUSTINE, FL
ZIP 32084-715
Phone: (904) 810-5434
Fax: (904) 810-5282

The NPI 1073617585 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Destruction of skin growth, 1-14 growths (HCPCS:17110)
  • Biopsy of related skin growth, first growth (HCPCS:11102)
  • Removal of impacted ear wax (HCPCS:69210)
  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Destruction of precancer skin growth, 15 or more growths (HCPCS:17004)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm (HCPCS:13132)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm (HCPCS:13131)
  • Injection, fluorouracil, 500 mg (HCPCS:J9190)
  • Biopsy of related skin growth, each additional growth (HCPCS:11103)
  • Removal of noncancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11442)
  • Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm (HCPCS:13151)
  • Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less (HCPCS:15260)
  • Removal of skin tag, 1-15 skin tags (HCPCS:11200)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 9/13/2006 and was last updated on 6/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Y00000XOtolaryngologyME91018FLORIDANo
2207YS0123XOtolaryngologyFacial Plastic SurgeryME91018FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00255496OTHERFLORIDARAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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