DEREK LEADERER (M.D.) – Vascular Surgery Physician, NPI 1104351980

DEREK LEADERER (M.D.) is a healthcare provider. based in Celebration, Florida. specializing in VASCULAR SURGERY. They hold the professional credentials M.D.. They hold a License No. ME174788 (FL). The NPI Number for DEREK LEADERER (M.D.) is 1104351980

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
DEREK LEADERER (M.D.)
NPI
1104351980
Phone
(407) 303-4080
Address
410 CELEBRATION PL STE 402
Enumeration Date
28 April 2017
Last Update Date
12 August 2025

Doctor Profile

Medical School Name
TUFTS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4073033824
Graduation Year
2017 (9 years ago)
PAC ID
9537432067
Group Practice PAC ID
0749186153
Professional Enrollment ID
I20250822001317
Address ID
FL347475435CE410XXPLXX302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Digital endpointsOther names

198 VASCULAR SURGERY in MA

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Provider Addresses for DEREK LEADERER (M.D.)

  • 410 CELEBRATION PL STE 402

    CELEBRATION, FL 347475436

    Phone: (407) 303-4080

    Fax: (407) 303-7255

    Type: Mailing

  • 804, Centre Street, Jamaica Plain, Boston, Suffolk County, Massachusetts, 02130, United States

    APT 302

    BOSTON, MA 021302760

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250822001317IVascular SurgeryFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34747)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749186153View full group profile
NameSpecialtyState
Physician AssistantFL
N E U R O L O G YFL
General SurgeryFL
Cardiovascular Disease (Cardiology), Internal Medicine, Interventional CardiologyFL
Nurse PractitionerFL
O B S T E T R I C S/ G Y N E C O L O G YFL
General SurgeryFL
Pulmonary Disease, Critical Care (Intensivists)FL
O B S T E T R I C S/ G Y N E C O L O G YMI
Physician AssistantFL

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Frequently asked questions

What NPI should I save for DEREK LEADERER (M.D.)?
Save NPI 1104351980 if you need a stable reference for DEREK LEADERER (M.D.).
Is DEREK LEADERER (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DEREK LEADERER (M.D.)?
The page reflects Vascular Surgery Physician for DEREK LEADERER (M.D.). Clinical services aligned with this taxonomy classification.
Where does public data place DEREK LEADERER (M.D.)?
The snapshot lists Celebration, Florida for DEREK LEADERER (M.D.); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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