Individual provider Active NPI

Leslie McCrary-Etuk, MD

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1174670418
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2011025936 Issued in MO
Practice address
1315 Aubert Ave
Saint Louis, MO 63113-1918
Phone
(314) 449-9726
Fax
(314) 449-9641
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2011025936 MO Primary

Addresses

Primary practice location

1315 Aubert Ave
Saint Louis, MO 63113-1918

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Other practice location 1

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820 ext. 2306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110930000583 MO Practitioner - Family Practice 9931203957 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archwell Health Professional Services of Kansas PAGroup PAC ID 4688072358, 25 clinicians
Carestl HealthGroup PAC ID 1557269289, 14 clinicians

Practice addresses (Care Compare)

1315 Aubert Ave
Saint Louis, MO 63113-1918
Phone (314) 449-9726

5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265
Phone (314) 367-5820

5541 Riverview Blvd
Saint Louis, MO 63120-2443
Phone (314) 389-4566

7047 Emma Ave
Jennings, MO 63136-1049
Phone (314) 653-8070

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Professional Services of Kansas, P.a. CurrentSince Dec 14, 2025 Accepting new patients
County of St Louis Division of Fiscal Management Past Accepting new patients

Locations

199 N Florissant Rd
Ferguson, MO 63135
Phone (314) 449-9640

1315 Aubert Ave
Saint Louis, MO 63113
Phone (314) 449-9726

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: leslie.mccraryetuk@cstl.eclinicaldirectplus.com

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.

Hospital & facility affiliations 1

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1174670418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 AUBERT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631131918",
            "telephone_number": "314-449-9726",
            "fax_number": "314-449-9641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5471 Dr Martin Luther King Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631124265",
            "country_code": "US",
            "telephone_number": "314-367-5820 x2306",
            "fax_number": "314-367-5820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCRARY-ETUK",
        "first_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2011025936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.