Active NPI
Charles Leduc, MD
- Anatomic Pathology Physician
- Rochester, MN
National Provider Identifier
1104222884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 273255-1
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Nov 7, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 273255-1 | NY | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
504 E 63Rd St
28 L
New York, NY 10065-7919
Phone (343) 333-4379
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58804 | Other | MN | MINNESOTA STATE MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 273255-1 | NY | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1104222884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 E 63RD ST",
"address_2": "28 L",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100657919",
"telephone_number": "343-333-4379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDUC",
"first_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-07",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "NY",
"license": "273255-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MINNESOTA STATE MEDICAL LICENSE",
"identifier": "58804",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.