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DR. LEONARD SIMON FAGAN M.D. NPI 1104812171


NPI Information

NPI: 1104812171
Provider Name: DR. LEONARD SIMON FAGAN, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
Organization: AURORA MEDICAL GROUP INC

PECOS Registration: Yes

Address:
10222 74TH STREET
SUITE 200
KENOSHA, WI
ZIP 53142
Phone: (262) 697-9200
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DR. Leonard Simon Fagan, M.D. is an obstetrics gynecology in Kenosha, WI with 40 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Leonard Simon Fagan, M.D. NPI is 1104812171. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduation Year:1984

The provider's business location address is:

10222 74TH STREET
SUITE 200
KENOSHA, WI
ZIP 53142-800
Phone: (262) 697-9200
Fax: (262) 697-9206

The NPI 1104812171 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.

  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)

The enumeration date for this NPI number is 9/23/2005 and was last updated on 12/1/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist46372-020WISCONSINNo
2207V00000XObstetrics & Gynecology46372WISCONSINYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
134485700MEDICAIDWISCONSIN

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.