Individual provider Active NPI

Leslie Keck, MD

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1174729800
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17411 Issued in NV
Practice address
2650 N Tenaya Way Ste 302
Las Vegas, NV 89128
Phone
(702) 240-0088
Fax
(702) 240-3049
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD038646 DC
Internal Medicine Physician 207R00000X 17411 NV Primary

Addresses

Primary practice location

2650 N Tenaya Way Ste 302
Las Vegas, NV 89128

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other identifiers 2

IdentifierTypeStateIssuer
1174729800MedicaidNV
17411OtherNVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180704000079 NV Practitioner - Internal Medicine 1254511819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
George Washington University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Medical Holdings Nevada IncGroup PAC ID 7416054622, 311 clinicians

Practice addresses (Care Compare)

2650 N Tenaya Way
Suite 360
Las Vegas, NV 89128-1102
Phone (702) 240-0088

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Holdings Nevada Inc Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Internal Medicine Current Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Healthcare Partners Medical Group (Coats) LTD. Past Accepting new patients
Talbert Medical Group Past Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

2650 N Tenaya Way
Ste 360
Las Vegas, NV 89128
Phone (702) 240-0088

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Interoperability endpoints

  • Direct secure messaging: lesliekeck@hcpnv.allscriptsdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1174729800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346",
            "fax_number": "702-671-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 N TENAYA WAY STE 302",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "702-240-0088",
            "fax_number": "702-240-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KECK",
        "first_name": "LESLIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD038646",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "17411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174729800",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "17411",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.