Lesley N Adibe, MD
Individual provider Active NPI Anesthesiology Physician · Kokomo, IN
NPI 1285775734 · NPPES record last updated Nov 17, 2016
Key facts
- NPI
- 1285775734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 01055301A (IN)
- Practice address
- 1907 W Sycamore St
Kokomo, IN 46901-5148 - Phone
- (765) 456-5433
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St. Joseph Primary Care, LLC
Practice addresses (Care Compare)
1907 W Sycamore St
Kokomo, IN 46901-5148
Phone (765) 456-5433
Hospital & facility affiliations
- Ascension St Vincent Kokomo
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080321000178 | IN | Practitioner - Anesthesiology | 7214903871 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Primary LLC | Current |
Accepting new patients | |
| St. Joseph Primary Care, LLC | Current |
Accepting new patients |
Locations
3109 W Sycamore St
Kokomo, IN 46901
Phone (765) 457-1191
1907 W Sycamore St
Kokomo, IN 46901
Phone (765) 452-5611
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01055301 | IN | |
| Anesthesiology Physician | 207L00000X | 01055301A | IN | Yes |
Addresses
Primary practice location
1907 W Sycamore St
Kokomo, IN 46901-5148
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000231407 | Other | IN | ANTHEM BCBS |
| 200395990 | Medicaid | IN |
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- Advanced Interventional Pain Center LLC
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All providers in Kokomo, IN · Anesthesiology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.