Leslie Jean Mortland, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

53414 Issued in MN

Practice address

1900 Centracare Cir # 1300
Centracare Clinic Health Plaza Pediatric and Adolescent
Saint Cloud, MN 56303-5000

Phone

(320) 654-3610

Fax

(320) 654-3647

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lmortland327482@direct.centracare.com

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.

• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • St Cloud, MN
  • NPI 1043212665
  Medicare reassignment NPD
• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment NPD
• St. Cloud Hospital

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1043269798
  Medicare reassignment NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD
• Centracare Clinic

  • Occupational Medicine Clinic/Center
  • Saint Cloud, MN
  • NPI 1366192759
  NPD
• Childrens Health Care

  • Anatomic Pathology & Clinical Pathology Physician
  • Minneapolis, MN
  • NPI 1053410928
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• St. Cloud Hospital

  • Home Health Agency
  • Waite Park, MN
  • NPI 1952350605
  NPD
• Wayzata Children'S Clinic P.a.

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1023081577
  NPD (past)
• Scottsdale Pediatrics and Pediatric Nephrology, PLLC

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1629076518
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1093859654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR # 1300",
            "address_2": "CENTRACARE CLINIC HEALTH PLAZA PEDIATRIC AND ADOLESCENT",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3610",
            "fax_number": "320-654-3647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR # 1300",
            "address_2": "CENTRACARE CLINIC HEALTH PLAZA PEDIATRIC AND ADOLESCENT",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-654-3610",
            "fax_number": "320-654-3647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTLAND",
        "first_name": "LESLIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "TRN9066",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "49019",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "WI",
            "license": "55982",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "53414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmortland327482@direct.centracare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "lmortland327482@direct.centracare.com",
            "address_1": "1900 Centracare Cir # 1300",
            "address_2": "CentraCare Clinic Health Plaza Pediatric and Adolescent",
            "city": "Saint Cloud",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563035000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter James Moriarty, D.D.S.
• Amber Lei Morrighan, M.A., LMFT
• Ryan D Morris, D.D.S.
• Ana Morse, M.S.
• Joel Stuart Morseth, LICSW
• Angela Dorothy Moscho, APRN
• Jasmine Mostoller, RBT
• Hannah Motschke
• Jennifer Sarah Mrnak-Meyer, PH.D., L.P.
• Mrs Sandman LLC

• Pediatrics Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.