Individual provider Active NPI

Leslie Ann Renfro, M.D.

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1093988230
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01069273A Issued in IN
Practice address
1120 South Driver
Fesler Hall, Room 204
Indianapolis, IN 46202-5135
Phone
(317) 274-0269
Fax
(317) 273-0256
NPI assigned
Apr 9, 2008
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01069273A IN Primary

Addresses

Primary practice location

1120 South Driver
Fesler Hall, Room 204
Indianapolis, IN 46202-5135

Mailing address

PO Box 6069-Dept 106
Indianapolis, IN 46206-6069
Phone (317) 614-9850

Other identifiers 1

IdentifierTypeStateIssuer
201067860MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200508000719 FL Practitioner - Anesthesiology 7719141373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boca Anesthesia Service IncGroup PAC ID 8325016975, 65 clinicians

Practice addresses (Care Compare)

800 Meadows Rd
Boca Raton, FL 33486-2304
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069273AINMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boca Anesthesia Service Inc Anesthesiology CurrentSince Apr 27, 2020 Accepting new patients
Boca Anesthesia Service Inc Anesthesiology CurrentSince Apr 27, 2020 Accepting new patients
Boca Anesthesia Service Inc Anesthesiology Current Accepting new patients

Locations

1905 Clint Moore Rd
Ste 115
Boca Raton, FL 33496
Phone (561) 509-5084

800 Meadows Rd
Boca Raton, FL 33486
Phone (561) 395-7100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1093988230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069-DEPT 106",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462066069",
            "telephone_number": "317-614-9850",
            "fax_number": "800-731-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 SOUTH DRIVER",
            "address_2": "FESLER HALL, ROOM 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025135",
            "telephone_number": "317-274-0269",
            "fax_number": "317-273-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENFRO",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01069273A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201067860",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.