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DR. LEONARD SIMON FAGAN M.D.
NPI 1104812171
Obstetrics & Gynecology in Kenosha, WI

Active since September 23, 2005PECOS Enrolled
10222 74TH STREET, SUITE 200, KENOSHA, WI 53142(262) 697-9200(262) 697-9206 Get Directions Write a Review

NPPES record last updated: October 3, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 3, 2022, Dec 1, 2021, Feb 24, 2020 and 2 more (5 updates tracked since 2019).

About Dr. Leonard Simon Fagan M.d. NPPES

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

DR. LEONARD SIMON FAGAN M.D. (NPI 1104812171) is an individual obstetrics & gynecology provider in Kenosha, Wisconsin, licensed in Florida (ME157114) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104812171
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. LEONARD SIMON FAGANCredential: M.D.
Location Address10222 74TH STREET, SUITE 200Kenosha, WI 53142-6800
Mailing Address3301 W Forest Home AveMilwaukee, WI 53215-2843 · (414) 389-2233
Phone(262) 697-9200
Fax(262) 697-9206
Sole ProprietorNo
Enumeration DateSeptember 23, 2005
Last NPPES UpdateOctober 3, 20225 updates tracked since enumeration
NPPES CertifiedOctober 3, 2022
✔ NPI 1104812171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Licenses✔ Licensed in FL · ME157114✔ Licensed in WI · 46372
Definition
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.
Also ListedSpecialistTaxonomy 174400000X · License 46372-020 (WI)
10222 74TH STREET, Kenosha, WI 53142
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Other Identifiers 1

Medicaid34485700WI

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Leonard Simon Fagan M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Leonard Fagan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ob Hospitalist Group LLC
838 mi
Obstetrics & Gynecology
1000 W MORENO ST
Pensacola, FL 32501
  • Reassigned Medicare billing, Florida enrollment
  • 683 clinicians in this Medicare group
NPI 1679292569 (864) 908-3530

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53142 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

MRS. ELIZABETH ANNE FIFIELD M.D.
Specialist
10222 74TH STREET, SUITE 200
KENOSHA, WI 53142
Kenosha County (262) 697-9200
MIDWEST CENTER FOR WOMENS HEALTH S.C.
Obstetrics & Gynecology
10222 74TH STREET, SUITE 200
KENOSHA, WI 53142
Kenosha County (262) 697-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leonard Fagan's NPI number?

The NPI number for Leonard Fagan is 1104812171. It was assigned to this individual provider in the NPPES registry on September 23, 2005.

Where is Leonard Fagan located?

Leonard Fagan practices at 10222 74th Street Suite 200, Kenosha, WI 53142. The listed phone number is (262) 697-9200.

What is Leonard Fagan's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Leonard Fagan enrolled in Medicare?

Yes. Leonard Fagan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Leonard Fagan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leonard Fagan reassigns Medicare benefits to Ob Hospitalist Group LLC (Pensacola, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Leonard Fagan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Leonard Fagan was last updated on October 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.