Individual provider Active NPI

Leslie Robinson-Bostom, M.D.

  • Dermatology Physician
  • Providence, RI
National Provider Identifier
1154368454
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD8906 Issued in RI
Practice address
593 Eddy St
Apc 10
Providence, RI 02903-4923
Phone
(401) 444-7959
Fax
(401) 444-7144
NPI assigned
Jun 2, 2006
Last updated
Jul 10, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X MD8906 RI
Dermatology Physician 207N00000X MD8906 RI Primary

Addresses

Primary practice location

593 Eddy St
Apc 10
Providence, RI 02903-4923

Mailing address

593 Eddy St
Apc 10
Providence, RI 02903-4923
Phone (401) 444-7959

Other identifiers 1

IdentifierTypeStateIssuer
9025124MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20050606000058 RI Practitioner - Dermatology 8022051796 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of New York Downstate Medical Center, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Dermatology IncGroup PAC ID 3870872773, 28 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, shared by 12 NPIs, 430 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-7245

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-7959

593 Eddy St
Apc 138
Providence, RI 02903-4900
Phone (401) 444-5435

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions412
Removal or shaving of skin growth1-10
Skin biopsy164

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD8906RIMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Oct 1, 2022 Accepting new patients
Newport Hospital CurrentSince Aug 13, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
The Miriam Hospital Current Accepting new patients
Newport Hospital CurrentSince Aug 13, 2015 Accepting new patients
The Miriam Hospital CurrentSince Mar 1, 2017 Accepting new patients
Rhode Island Hospital Dermatopathology CurrentSince Feb 5, 2017 Accepting new patients
Brown Dermatology, Inc. Dermatology CurrentSince Jan 1, 2017 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

407 East Ave
Ste 200
Pawtucket, RI 02860
Phone (401) 312-0023

593 Eddy St
#921
Providence, RI 02903
Phone (401) 444-3250

593 Eddy St
#10
Providence, RI 02903
Phone (401) 444-7024

593 Eddy St
Providence, RI 02903

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

164 Summit Ave
Ste C
Providence, RI 02906
Phone (401) 793-2931

164 Summit Ave
Ste 2D
Providence, RI 02906

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

593 Eddy St
#138
Providence, RI 02903
Phone (401) 444-5291

375 Wampanoag Trl
Ste 401
Riverside, RI 02915
Phone (401) 632-4455

65 Village Square Dr
Ste 201
South Kingstown, RI 02879
Phone (401) 515-7979

400 Bald Hill Rd
Warwick, RI 02886
Phone (401) 352-0005

17 Wells St
Ste 203
Westerly, RI 02891
Phone (401) 348-0660

Organizations & group practices 12

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 5

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1154368454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "APC 10",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-7959",
            "fax_number": "401-444-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "APC 10",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-7959",
            "fax_number": "401-444-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON-BOSTOM",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "RI",
            "license": "MD8906",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "MD8906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025124",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.