NPIMap

Individual provider Active NPI

Kristel Dawn Leubner, DO

  • Family Medicine Physician
  • Caldwell, TX
National Provider Identifier
1316069982
Registry record updated Oct 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M4855 Issued in TX
Practice address
1103 Woodson Dr
Caldwell, TX 77836-1052
Phone
(979) 567-7080
Fax
(979) 567-9783
NPI assigned
Apr 4, 2007
Last updated
Oct 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M4855 TX Primary

Addresses

Primary practice location

1103 Woodson Dr
Caldwell, TX 77836-1052

Mailing address

1103 Woodson Dr
Caldwell, TX 77836-1052
Phone (979) 567-7080

Other identifiers 1

IdentifierTypeStateIssuer
190219901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20070717000609 TX Practitioner - Family Practice 4486754652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1103 Woodson Dr
Caldwell, TX 77836-1052
Phone (979) 567-7080

3370 S Texas Ave
Bryan, TX 77802-3127
Phone (979) 595-1700

8310 Hwy 6 Loop
Navasota, TX 77868-3248
Phone (936) 825-0000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Community Action Agency, Inc. Current Accepting new patients
Brazos Valley Community Action Agency, Inc. CurrentSince Aug 14, 2024 Accepting new patients
Brazos Valley Community Action Agency, Inc. CurrentSince Aug 14, 2024 Accepting new patients
Burleson County Hospital District Past Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

1103 Woodson Dr
Caldwell, TX 77836
Phone (979) 567-7080

1500 University Dr E
College Station, TX 77840
Phone (979) 693-7400

1500 University Dr E
Ste 100
College Station, TX 77840
Phone (979) 383-2340

8310 Highway 6 Loop
Navasota, TX 77868
Phone (936) 825-0000

Interoperability endpoints

  • Direct secure messaging: kleubner@caldwellhltpt.direct.st-joseph.md

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

Hospital & facility affiliations 6

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254441600000",
    "number": "1316069982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 WOODSON DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778361052",
            "telephone_number": "979-567-7080",
            "fax_number": "979-567-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 WOODSON DR",
            "city": "CALDWELL",
            "state": "TX",
            "postal_code": "778361052",
            "telephone_number": "979-567-7080",
            "fax_number": "979-567-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUBNER",
        "first_name": "KRISTEL",
        "middle_name": "DAWN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M4855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190219901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, TX

Sources for this page

Verify at the official NPI Registry.