Individual provider Active NPI

Kevin Andrew Lease, MD

  • Internal Medicine Physician
  • Jefferson City, MO
National Provider Identifier
1083909055
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2012033009 Issued in MO
Practice address
1125 Madison St
Jefferson City, MO 65101-5227
Phone
(573) 634-2620
Fax
(573) 634-2033
NPI assigned
Jun 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2012033009 MO Primary

Addresses

Primary practice location

1125 Madison St
Jefferson City, MO 65101-5227

Mailing address

1125 Madison St
Jefferson City, MO 65101-5227
Phone (573) 634-2620

Other practice location 1

101 S Fairview Rd
Columbia, MO 65203-5615
Phone (573) 882-4464

Other identifiers 1

IdentifierTypeStateIssuer
200015269MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MUDOCREFERRAL@direct.health.missouri.edu Direct Curators of the University of Missouri

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140805002189 MO Practitioner - Internal Medicine 2163650953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Curators of the University of MissouriGroup PAC ID 4486759560, 1,108 clinicians

Practice addresses (Care Compare)

101 S Fairview Rd
Columbia, MO 65203-7637
Phone (573) 884-7600

Hospital & facility affiliations

  • Capital Region Home Health Home health agency, Jefferson City, MO, CCN 267219
  • Central Missouri Home Health Home health agency, Jefferson City, MO, CCN 267448
  • Phoenix Home Care Home health agency, Jefferson City, MO, CCN 267597
  • Elara Caring Home health agency, Jefferson City, MO, CCN 267600
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068
  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
58.17
Promoting interoperability
100
Improvement activities
40
Cost
75.92

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri CurrentSince May 19, 2022 Accepting new patients
The Curators of the University of Missouri CurrentSince May 19, 2022 Accepting new patients

Locations

1000 W Nifong Blvd
Ste 130
Columbia, MO 65203
Phone (573) 424-2592

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

101 S Fairview Rd
Columbia, MO 65203
Phone (573) 882-1095

1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000

901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666

Organizations & group practices 2

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 10

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": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1083909055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-634-2620",
            "fax_number": "573-634-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-634-2620",
            "fax_number": "573-634-2033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S FAIRVIEW RD",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652035615",
            "country_code": "US",
            "telephone_number": "573-882-4464",
            "fax_number": "573-884-8142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEASE",
        "first_name": "KEVIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012033009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200015269",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
            "affiliation": "Y",
            "endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
            "affiliationName": "Curators of the University of Missouri",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "101 S FAIRVIEW RD",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652035615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.