Individual provider Active NPI

Lesley A. McPeak, M.D.

  • Pediatrics Physician
  • Yulee, FL
National Provider Identifier
1114239324
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME132802 Issued in FL
Practice address
76011 William Burgess Blvd
Yulee, FL 32097-5428
Phone
(904) 427-8583
NPI assigned
Jul 6, 2010
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME132802 FL Primary

Addresses

Primary practice location

76011 William Burgess Blvd
Yulee, FL 32097-5428

Mailing address

PO Box 44008
Jacksonville, FL 32231-4008
Phone (904) 244-3566

Other identifiers 1

IdentifierTypeStateIssuer
023354100MedicaidFL

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
I20231020001309 FL Practitioner - Pediatric Medicine 2264678861 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME132802FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince Sep 15, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Sep 15, 2023 Accepting new patients
Saltzman, Tanis, Pittell, Levin and Jacobson, LLC Pediatrics PastSince Dec 3, 2023 Accepting new patients
Pediatric Associates of Tampa Bay, Inc Pediatrics Past Accepting new patients

Locations

1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110

76011 William Burgess Blvd
Yulee, FL 32097
Phone (352) 273-5801

Interoperability endpoints

  • Direct secure messaging: lmcpeak645141@direct.shands.ufl.edu

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1114239324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3566",
            "fax_number": "904-244-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76011 WILLIAM BURGESS BLVD",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320975428",
            "telephone_number": "904-427-8583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPEAK",
        "first_name": "LESLEY",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-06",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME132802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023354100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yulee, FL

Sources for this page

Verify at the official NPI Registry.