Active NPI
Leslie Romersberger
- Physician Assistant
- Pontiac, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085003656
- Practice address
- 2500 W Reynolds St
Pontiac, IL 61764-9774 - Phone
- (815) 844-5343
- NPI assigned
- Nov 5, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085003656 | IL | Primary |
Addresses
Primary practice location
2500 W Reynolds St
Pontiac, IL 61764-9774
Mailing address
2500 W Reynolds St
Pontiac, IL 61764-9774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 833230 | Other | MEDICARE GROUP # |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202
4571 Colonial Blvd
Fort Myers, FL 33966-1156
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085003656 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesiscare USA of Florida LLC | Current | Accepting new patients | |
| Genesiscare USA of Florida LLC | Current | Accepting new patients | |
| Genesiscare USA of Florida LLC | Past | Accepting new patients |
Locations
1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202
4571 Colonial Blvd
Ste 210
Fort Myers, FL 33966
Phone (239) 274-7600
13770 Plantation Rd
Ste 2
Fort Myers, FL 33912
Phone (239) 275-0728
4571 Colonial Blvd
Ste 110
Fort Myers, FL 33966
Phone (239) 226-2727
730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119
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.
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- Boca Raton, FL
- NPI 1649093709
-
- Medical Oncology Physician
- Aventura, FL
- NPI 1992114235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1104153550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 W REYNOLDS ST",
"city": "PONTIAC",
"state": "IL",
"postal_code": "617649774",
"telephone_number": "815-844-5343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMERSBERGER",
"first_name": "LESLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-05",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085003656",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "833230",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pontiac, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.