NPIMap

Individual provider Active NPI

Leslie Copeland Dominguez, M.D.

  • Internal Medicine Physician
  • Covington, LA
National Provider Identifier
1124059639
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26181 Issued in LA
Practice address
1202 S Tyler St
Covington, LA 70433-2330
Phone
(985) 898-4000
Fax
(985) 898-4164
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26181 LA Primary

Addresses

Primary practice location

1202 S Tyler St
Covington, LA 70433-2330

Mailing address

PO Box 54482
New Orleans, LA 70154-4482
Phone (985) 898-4000

Other identifiers 2

IdentifierTypeStateIssuer
08504875MedicaidMS
1049743MedicaidLA

Other names 1

  • Dr. Leslie Augusta Copeland Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000867 LA Practitioner - Internal Medicine 8628044914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Tammany Parish Hospital Service District No 1Group PAC ID 0749273761, 162 clinicians

Practice addresses (Care Compare)

1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-3743

Hospital & facility affiliations

  • St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26181LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Tammany Parish Hospital Service District No 1 CurrentSince Jan 1, 2015 Accepting new patients
St Tammany Parish Hospital Service District No 1 Internal Medicine CurrentSince Apr 23, 2007 Accepting new patients
St. Tammany Parish Hospital Service District No 1 CurrentSince Apr 23, 2007 Accepting new patients
St. Tammany Parish Hospital Service District No 1 Current Accepting new patients
Ochsner Clinic LLC Internal Medicine Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

606 W 11th Ave
#A
Covington, LA 70433
Phone (985) 892-3766

Organizations & group practices 9

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1124059639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54482",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701544482",
            "telephone_number": "985-898-4000",
            "fax_number": "985-898-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 S TYLER ST",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330",
            "telephone_number": "985-898-4000",
            "fax_number": "985-898-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "LESLIE",
        "middle_name": "COPELAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "26181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08504875",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1049743",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "COPELAND",
            "middle_name": "AUGUSTA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.