Active NPI
Nicholas Richard Levergood, MD
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Plastic and Reconstructive Surgery Physician
- License
- 2026010211
- Practice address
- 4901 Forest Park Ave
Dept Ophthalmology, 6TH FL
Saint Louis, MO 63108-1495 - Phone
- (314) 362-3937
- Fax
- (866) 505-8818
- NPI assigned
- Apr 2, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Plastic and Reconstructive Surgery Physician | 207WX0200X | 2026010211 | MO | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Ophthalmology Physician | 207W00000X | 01093315A | IN |
Addresses
Primary practice location
4901 Forest Park Ave
Dept Ophthalmology, 6TH FL
Saint Louis, MO 63108-1495
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (317) 362-3937
Other practice location 1
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104332803 | Other | IN | ANTHEM PTAN |
| 300051678 | Medicaid | IN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Tufts University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Hospital & facility affiliations
- Indiana University Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01093315A | IN | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Clinic-Neurology, LLC | Current | Accepting new patients | |
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Major Hospital | Ophthalmology | Past | Accepting new patients |
Locations
3879 Reliable Pkwy
Chicago, IL 60686
350 S Landmark Ave
Bloomington, IN 47403
Phone (812) 332-9874
1801 Senate Blvd
Ste 620
Indianapolis, IN 46202
Phone (317) 926-6699
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1160 W Michigan St
Indianapolis, IN 46202
Phone (317) 274-2128
355 W 16th St
Ste 3200
Indianapolis, IN 46202
Phone (317) 963-7400
720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000
355 W 16th St
Indianapolis, IN 46202
Phone (317) 963-7070
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
720 Eskenazi Ave
Fl 6
Indianapolis, IN 46202
Phone (317) 880-0000
Interoperability endpoints
- nlevergood87378@direct.eskenazihealth.edu
- nlevergood@direct.iuhealth.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Neurology Physician
- Indianapolis, IN
- NPI 1578792271
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Indianapolis, IN
- NPI 1144266024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1033748108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412011",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742011",
"telephone_number": "317-362-3937",
"fax_number": "866-505-8818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4901 FOREST PARK AVE",
"address_2": "DEPT OPHTHALMOLOGY, 6TH FL",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631081495",
"telephone_number": "314-362-3937",
"fax_number": "866-505-8818"
}
],
"practiceLocations": [
{
"address_1": "915 N Grand Blvd",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631061621",
"country_code": "US",
"telephone_number": "314-652-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEVERGOOD",
"first_name": "NICHOLAS",
"middle_name": "RICHARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-02",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207WX0200X",
"taxonomy_group": "",
"desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
"state": "MO",
"license": "2026010211",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IN",
"license": "01093315A",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PTAN",
"identifier": "1104332803",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300051678",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4901 Forest Park Ave",
"address_2": "Dept Ophthalmology, 6th Fl",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631081495",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.