Leslie Ann Las, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

9582-33 Issued in WI

Practice address

500 East Veterans Street
Tomah, WI 54660

Phone

(608) 372-3971

Fax

(608) 371-1692

NPI assigned

Oct 3, 2019

Last updated

Apr 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Leslie Ann Neldner Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  Nurse Practitioner, WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1275174922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EAST VETERANS STREET",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "54660",
            "telephone_number": "608-372-3971",
            "fax_number": "608-371-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EAST VETERANS STREET",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "54660",
            "telephone_number": "608-372-3971",
            "fax_number": "608-371-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAS",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "9582-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "NELDNER",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "REGISTERED NURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David P Larsen, OD
• Erik Paul Logen Larsen, PHARMD
• Kayleen Raye Larson
• Kyle Larson
• Megan Nicole Larson, RN
• Andrew Last, MD
• Debrah Latella
• Joseph John Lawrence, O.D.
• Emili Jeanne-Watts Leary, PHARMD
• Reisha Kay Lenz, RD

• Nurse Practitioner in Tomah, WI
• Providers in Tomah, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.