Individual provider Active NPI

Nicholas Richard Levergood, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1033748108
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
2026010211 Issued in MO
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

Updated by the provider on Aug 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1104332803OtherINANTHEM PTAN
300051678MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241017000814 IN Practitioner - Ophthalmology 4385075563 Reassigns benefits to 2 organizations
I20260610001776 MO Practitioner - Ophthalmology 4385075563

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
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01093315AINMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana Clinic-Neurology, LLC CurrentSince Oct 14, 2024 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 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

  • Direct secure messaging: nlevergood87378@direct.eskenazihealth.edu
  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.