Individual provider Active NPI

Leah Rose Glass, D.O.

  • Obstetrics & Gynecology Physician
  • O Fallon, MO
National Provider Identifier
1093942997
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2009015812 Issued in MO
Practice address
300 Winding Woods Dr
Suite 200
O Fallon, MO 63366-4771
Phone
(636) 240-0130
Fax
(636) 240-6822
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2009015812 MO Primary

Addresses

Primary practice location

300 Winding Woods Dr
Suite 200
O Fallon, MO 63366-4771

Mailing address

300 Winding Woods Dr
Suite 200
O Fallon, MO 63366-4771
Phone (636) 240-0130

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
I20131023001959 MO Practitioner - Obstetrics/Gynecology 5294960472 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, shared by 6 NPIs, 573 clinicians

Practice addresses (Care Compare)

15945 Clayton Rd
Ballwin, MO 63011-2490
Phone (636) 256-5070

15945 Clayton Rd
Suite 360C
Ballwin, MO 63011-2382
Phone (636) 256-5090

300 Winding Woods Dr
Suite 100
O Fallon, MO 63366-5080
Phone (636) 240-0130

621 S New Ballas Rd
Suite 189a
Saint Louis, MO 63141-8255
Phone (314) 251-6335

621 S New Ballas Rd
Suite 4017B
Saint Louis, MO 63141-8269
Phone (314) 872-9192

Hospital & facility affiliations

  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2009015812MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Mar 1, 2017 Accepting new patients
Mercy Hospitals East Communities CurrentSince Mar 1, 2017 Accepting new patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Apr 7, 2020 Accepting new patients
Mercy Clinic East Communities Obstetrics & Gynecology CurrentSince Sep 3, 2013 Accepting new patients
Mercy Clinic East Communities Obstetrics & Gynecology Current Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients

Locations

15945 Clayton Rd
Ste 360C
Ballwin, MO 63011
Phone (636) 256-5090

300 Winding Woods Dr
Ste 100
O Fallon, MO 63366
Phone (636) 240-0130

300 Winding Woods Dr
Ste 200
O Fallon, MO 63366
Phone (636) 240-0130

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101

Interoperability endpoints

  • Direct secure messaging: lglass98714@directc.mercy.net

Organizations & group practices 6

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 3

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1093942997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WINDING WOODS DR",
            "address_2": "SUITE 200",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633664771",
            "telephone_number": "636-240-0130",
            "fax_number": "636-240-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WINDING WOODS DR",
            "address_2": "SUITE 200",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633664771",
            "telephone_number": "636-240-0130",
            "fax_number": "636-240-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASS",
        "first_name": "LEAH",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2009015812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.