Individual provider Active NPI

Leslie A Hass, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Twin Falls, ID
National Provider Identifier
1275913824
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP-1571A Issued in ID
Practice address
475 Polk St Ste F
Twin Falls, ID 83301-4864
Phone
(208) 751-9708
Fax
(208) 736-0890
NPI assigned
Jun 8, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP-1571A ID
Adult Health Nurse Practitioner 363LA2200X NP-1571A ID Primary

Addresses

Primary practice location

475 Polk St Ste F
Twin Falls, ID 83301-4864

Mailing address

3704 N 2200 E
Filer, ID 83328-5260
Phone (208) 751-9708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20151229000888 ID Practitioner - Nurse Practitioner 8123129285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

475 Polk St
Suite F
Twin Falls, ID 83301-4864
Phone (208) 751-9097

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP-1571AIDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Body & Mind Wellness LLC Family CurrentSince Sep 27, 2023 Accepting new patients

Locations

414 N Lincoln Ave
Jerome, ID 83338
Phone (208) 324-5431

475 Polk St
Ste F
Twin Falls, ID 83301
Phone (208) 751-9097

Interoperability endpoints

  • Direct secure messaging: leslie.hass@bmwc-id.direct.office.nextgen.com

Organizations & group practices 1

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 2

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": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1275913824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 N 2200 E",
            "city": "FILER",
            "state": "ID",
            "postal_code": "833285260",
            "telephone_number": "208-751-9708",
            "fax_number": "208-736-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 POLK ST STE F",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014864",
            "telephone_number": "208-751-9708",
            "fax_number": "208-736-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASS",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-08",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ID",
            "license": "NP-1571A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "NP-1571A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.