LEONARDO JOSE DIAZ GANDICA MD
NPI 1003659269
Student in an Organized Health Care Education/Training Program in Greenville, NC

Q: What is Leonardo Diaz Gandica's NPI number?

The NPI number for Leonardo Diaz Gandica is 1003659269. It was assigned to this individual provider in the NPPES registry on June 17, 2024.

Q: What is Leonardo Diaz Gandica's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since June 17, 2024PECOS Enrolled

2100 STANTONSBURG RD, GREENVILLE, NC 27834(252) 744-5291(252) 744-0013 Get Directions Write a Review

NPPES record last updated: July 7, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 7, 2025, Jun 22, 2025, Jun 17, 2024 (3 updates tracked since 2024).

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About Leonardo Jose Diaz Gandica Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEONARDO JOSE DIAZ GANDICA MD (NPI 1003659269) is an individual student in an organized health care education/training program in Greenville, North Carolina, licensed in North Carolina (RTL25-1042) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003659269

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameLEONARDO JOSE DIAZ GANDICACredential: MD

Location Address2100 STANTONSBURG RDGreenville, NC 27834-2818

Mailing Address105 W Victoria Ct Apt AGreenville, NC 27834-7639 · (314) 489-7402

Phone(252) 744-5291

Fax(252) 744-0013

Sole ProprietorNo

Enumeration DateJune 17, 2024

Last NPPES UpdateJuly 7, 20253 updates tracked since enumeration

NPPES CertifiedJuly 7, 2025

✔ NPI 1003659269 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in NC · RTL25-1042

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2100 STANTONSBURG RD, Greenville, NC 27834

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Leonardo Jose Diaz Gandica Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHRYN M DONATO CRNA

Nurse Anesthetist, Certified Registered