Individual provider Active NPI

Leah Brancheck, M.D.

  • Neurology Physician
  • Chesterfield, MO
National Provider Identifier
1255747119
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2017038573 Issued in MO
Practice address
111 Saint Lukes Center Dr Ste 20B
Chesterfield, MO 63017-3509
Phone
(636) 685-7745
NPI assigned
Jul 10, 2014
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2017038573 MO Primary

Addresses

Primary practice location

111 Saint Lukes Center Dr Ste 20B
Chesterfield, MO 63017-3509

Mailing address

111 Saint Lukes Center Dr Ste 20B
Chesterfield, MO 63017-3509
Phone (636) 685-7745

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
I20190715002936 MO Practitioner - Neurology 8820218522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
State University of Ny Upstate Medical University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurosurgery and Neurology LLCGroup PAC ID 2769412246, 13 clinicians
Elite Physical Therapy of Creve Coeur LLCGroup PAC ID 7719280841, 85 clinicians

Practice addresses (Care Compare)

111 Saint Lukes Ctr Dr
Suite 20B
Chesterfield, MO 63017-3509
Phone (636) 685-7745

12788 Olive Blvd
Creve Coeur, MO 63141-6211

15425 Manchester Rd
Suite 28
Ballwin, MO 63011-3077
Phone (636) 220-6969

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017038573MOMDNeurology Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1255747119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SAINT LUKES CENTER DR STE 20B",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173509",
            "telephone_number": "636-685-7745",
            "fax_number": "314-576-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SAINT LUKES CENTER DR STE 20B",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173509",
            "telephone_number": "636-685-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCHECK",
        "first_name": "LEAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": "2017038573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.