Individual provider Active NPI

Manuel Le-Yeng San, D.O.

  • Family Medicine Physician
  • Columbia, MO
National Provider Identifier
1245443548
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2006029319 Issued in MO
Practice address
2101 Corona Rd Ste 102
Columbia, MO 65203-2582
Phone
(573) 234-1800
Fax
(573) 234-1799
NPI assigned
May 7, 2007
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2006029319 MO Primary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 2006029319 MO

Addresses

Primary practice location

2101 Corona Rd Ste 102
Columbia, MO 65203-2582

Mailing address

2101 Corona Rd Ste 102
Columbia, MO 65203-2582
Phone (573) 234-1800

Other identifiers 3

IdentifierTypeStateIssuer
1245443548MedicaidMO
P00770996OtherMORR MEDICARE PTAN
207024605MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address manuel.san@BHM.gehrimeddirect.com

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
I20080424000058 MO Practitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Geriatric Medicine 2567540040 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CH Specialty Services Mo LLCGroup PAC ID 0345614459, 108 clinicians
Curana Health of Missouri-Kansas LLCGroup PAC ID 4789716531, 143 clinicians

Practice addresses (Care Compare)

11278 Schuetz Rd
Saint Louis, MO 63146-4957
Phone (337) 991-9276

403 W Main St
Good Samaritan Nursing Home
Cole Camp, MO 65325-1144
Phone (737) 226-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006029319MOMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CH Specialty Services Mo LLC CurrentSince Oct 24, 2024 Accepting new patients
Barnes Health LLC CurrentSince Jul 16, 2023 Accepting new patients
Barnes Health Care Management Group LLC CurrentSince Jul 14, 2021 Accepting new patients
Fast Track Medical LLC CurrentSince Mar 1, 2016 Accepting new patients
Fast Track Medical LLC CurrentSince Mar 1, 2016 Accepting new patients
Fast Track Urgent Care LLC Current Accepting new patients
Bel Oak of Country View LLC Past Accepting new patients
Country View Nursing Facility, Inc. Past Accepting new patients
The Estates of Spanish Lake, LLC Past Accepting new patients
Geriatric Healthcare Services, LLC Past Accepting new patients
The Estates of St. Louis, LLC Past Accepting new patients
NBH1 Mtopco LLC Past Accepting new patients
Brook View Nursing Home, Inc. Past Accepting new patients
Community Care Center of Louisiana, Inc Past Accepting new patients
Mercy Clinic Palliative Care, LLC Past Accepting new patients
St Charles Opco LLC Past Accepting new patients
Geriatric Health Services, Inc. Geriatric Medicine Past Accepting new patients
Bel Oak of Lemay LLC Past Accepting new patients
Windsor Estates of St Charles Snal, LLC Past Accepting new patients
Community Care Center of Mark Twain Inc Past Accepting new patients
NBH2 Mgopco LLC Past Accepting new patients
Fast Track Medical LLC PastSince Apr 14, 2024 Accepting new patients
Bel Oak of Mark Twain, LLC Past Accepting new patients

Locations

2106 W Main St
Bowling Green, MO 63334
Phone (573) 324-2216

403 W Main St
Cole Camp, MO 65325
Phone (660) 668-4515

2101 Corona Rd
Ste 102
Columbia, MO 65203
Phone (573) 234-1800

2686 N Highway 67
Florissant, MO 63033
Phone (314) 436-9300

1734 Market St
Hannibal, MO 63401
Phone (573) 221-2930

1333 Scenic Dr
Herculaneum, MO 63048
Phone (636) 931-2995

3980 E Jackson Dr
Independence, MO 64057
Phone (816) 743-4378

11515 Troost Ave
Kansas City, MO 64131
Phone (813) 943-4104

2323 E 63rd St
Kansas City, MO 64130
Phone (816) 444-8161

621 Carondelet Dr
Kansas City, MO 64114
Phone (816) 941-1300

7900 Lees Summit Rd
Kansas City, MO 64139
Phone (816) 373-4485

400 SW Longview Blvd
Ste 200
Lees Summit, MO 64081
Phone (816) 477-7200

600 NW Pryor Rd
Lees Summit, MO 64081
Phone (816) 251-8000

2920 Fee Fee Rd
Maryland Hts, MO 63043
Phone (314) 291-0121

620 E Monroe St
Mexico, MO 65265
Phone (573) 582-5000

2041 Silva Ln
Moberly, MO 65270
Phone (660) 263-1894

2150 W Randolph St
Saint Charles, MO 63301
Phone (636) 946-4966

11278 Schuetz Rd
Saint Louis, MO 63146
Phone (314) 991-4066

4401 N Hanley Rd
Saint Louis, MO 63134
Phone (314) 521-7471

5701 Chippewa St
Saint Louis, MO 63109
Phone (314) 921-7300

9845 West Florissant Ave
Saint Louis, MO 63136
Phone (314) 736-6100

2800 Highway TT
#Four
Sedalia, MO 65301
Phone (660) 826-8803

1101 W Clay Rd
Versailles, MO 65084
Phone (573) 378-5312

1441 Charic Dr
Wildwood, MO 63021
Phone (636) 394-2522

Interoperability endpoints

  • Direct secure messaging: manuel.san@bhm.gehrimeddirect.com

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Country View NursingBowling Green, MO, CCN 265419 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jun 1, 2024
Jun 1, 2024
Avenir at Maple GroveLouisiana, MO, CCN 265740 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Oct 1, 2025
Oct 1, 2025
Avenir at Mark TwainBridgeton, MO, CCN 265236 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Oct 1, 2025
Oct 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 9

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1245443548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CORONA RD STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032582",
            "telephone_number": "573-234-1800",
            "fax_number": "573-234-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 CORONA RD STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652032582",
            "telephone_number": "573-234-1800",
            "fax_number": "573-234-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN",
        "first_name": "MANUEL",
        "middle_name": "LE-YENG",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2006029319",
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MO",
            "license": "2006029319",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245443548",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN",
            "identifier": "P00770996",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207024605",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manuel.san@BHM.gehrimeddirect.com",
            "affiliation": "N",
            "address_1": "2101 Corona Rd Ste 102",
            "city": "Columbia",
            "state": "MO",
            "country_code": "US",
            "postal_code": "652032582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.