NPIMap

Individual provider Active NPI

Jeremy Earle Leidenfrost, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chesterfield, MO
National Provider Identifier
1275739872
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2012032509 Issued in MO
Practice address
222 S Woods Mill Rd
#550N
Chesterfield, MO 63017-3625
Phone
(314) 434-3049
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2007016635 MO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2012032509 MO Primary

Addresses

Primary practice location

222 S Woods Mill Rd
#550N
Chesterfield, MO 63017-3625

Mailing address

222 S Woods Mill Rd
#550N
Chesterfield, MO 63017-3625
Phone (314) 434-3049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140602001401 MO Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 2163650102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Saint Louis University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiothoracic Surgery, LLCGroup PAC ID 1254365281, 14 clinicians

Practice addresses (Care Compare)

222 S Woods Mill Rd
Suite 550N
Chesterfield, MO 63017-3641
Phone (314) 434-3049

Hospital & facility affiliations

  • St Luke'S Home Health Services Home health agency, Chesterfield, MO, CCN 267561
  • Aw Health Care Home health agency, Saint Louis, MO, CCN 267585
  • Ozark Home Healthcare Home health agency, Poplar Bluff, MO, CCN 267662
  • Phelps Health Home Health and Hospice Home health agency, Rolla, MO, CCN 267555
  • Elara Caring Home health agency, Farmington, MO, CCN 267592
  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179
  • Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)53
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007016635MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince May 23, 2024 Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC CurrentSince May 23, 2024 Accepting new patients
Cardiothoracic Surgery, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jul 1, 2014 Accepting new patients
St. Lukes Episcopal-Presbyterian Hospital Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

226 S Woods Mill Rd
Ste 550
Chesterfield, MO 63017

222 S Woods Mill Rd
Ste 550N
Chesterfield, MO 63017
Phone (314) 434-3049

222 S Woods Mill Rd
Ste 550
Chesterfield, MO 63017
Phone (314) 434-3049

10012 Kennerly Rd
Ste 101
Saint Louis, MO 63128
Phone (314) 525-4325

625 S New Ballas Rd
#R7040
Saint Louis, MO 63141

Organizations & group practices 5

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.

Hospital & facility affiliations 12

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": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1275739872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "address_2": "#550N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-434-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "address_2": "#550N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-434-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDENFROST",
        "first_name": "JEREMY",
        "middle_name": "EARLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2007016635",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2012032509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.