Active NPI
Leonard David Gaum, MD
- Urology Physician
- Saint Louis, MO
National Provider Identifier
1245288760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- R4A96
- Practice address
- 607 S New Ballas Rd
Suite 3100
Saint Louis, MO 63141-8222 - Phone
- (314) 251-8850
- Fax
- (314) 569-3846
- NPI assigned
- May 5, 2006
- Last updated
- Dec 3, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | R4A96 | MO | Primary |
Addresses
Primary practice location
607 S New Ballas Rd
Suite 3100
Saint Louis, MO 63141-8222
Mailing address
607 S New Ballas Rd
Suite 3100
Saint Louis, MO 63141-8222
Phone (314) 251-8850
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245288760 | Medicaid | MO | |
| 201244514 | Medicaid | MO | |
| P01201857 | Other | MO | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Surgical Specialists, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Vascular Surgery Physician
- Washington, MO
- NPI 1043530538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417564800000",
"number": "1245288760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 S NEW BALLAS RD",
"address_2": "SUITE 3100",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418222",
"telephone_number": "314-251-8850",
"fax_number": "314-569-3846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 S NEW BALLAS RD",
"address_2": "SUITE 3100",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418222",
"telephone_number": "314-251-8850",
"fax_number": "314-569-3846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUM",
"first_name": "LEONARD",
"middle_name": "DAVID",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2014-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MO",
"license": "R4A96",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1245288760",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201244514",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01201857",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.