Individual provider Active NPI

Wendy J Leslie, O.D.

  • Optometrist
  • Hyannis, MA
National Provider Identifier
1255307930
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2495 Issued in MA
Practice address
113 Corporation St
Hyannis, MA 02601-2204
Phone
(508) 778-9473
Fax
(508) 775-5913
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2495 MA Primary

Addresses

Primary practice location

113 Corporation St
Hyannis, MA 02601-2204

Mailing address

113 Corporation St
Hyannis, MA 02601-2204
Phone (508) 778-9473

Other identifiers 5

IdentifierTypeStateIssuer
000000031920OtherMABMC HEALTHNET
0343404MedicaidMA
779637OtherMATUFTS
150674OtherMAPILGRIM
W16120OtherMABC/BS OF MA/HMO BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120118000463 MA Practitioner - Optometry 7810164753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mall Vision Center LLCGroup PAC ID 9830453554, 2 clinicians

Practice addresses (Care Compare)

113 Corporation St
Hyannis, MA 02601-2204
Phone (508) 778-9473

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001MAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Mall Vision Center, LLC CurrentSince Feb 2, 2018 Accepting new patients
Barnstable Eye PC Optometrist PastSince Feb 2, 2018 Accepting new patients

Locations

113 Corporation St
Hyannis, MA 02601
Phone (508) 478-9473

Organizations & group practices 2

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1255307930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 CORPORATION ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026012204",
            "telephone_number": "508-778-9473",
            "fax_number": "508-775-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CORPORATION ST",
            "city": "HYANNIS",
            "state": "MA",
            "postal_code": "026012204",
            "telephone_number": "508-778-9473",
            "fax_number": "508-775-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "WENDY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "2495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000031920",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0343404",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "779637",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PILGRIM",
            "identifier": "150674",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MA/HMO BLUE",
            "identifier": "W16120",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyannis, MA

Sources for this page

Verify at the official NPI Registry.