Individual provider Active NPI

Leslie M. Golden, MD

  • Family Medicine Physician
  • Watertown, WI
National Provider Identifier
1336401736
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64027-20 Issued in WI
Practice address
123 Hospital Dr Ste 212
Watertown, WI 53098-3336
Phone
(920) 471-4044
Fax
(920) 471-4044
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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 64027-20 WI Primary

Addresses

Primary practice location

123 Hospital Dr Ste 212
Watertown, WI 53098-3336

Mailing address

123 Hospital Dr Ste 212
Watertown, WI 53098-3336
Phone (920) 471-4044

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805006493 WI Practitioner - Family Practice 9739344094 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weight in Gold Wellness SCGroup PAC ID 6305202110, 10 clinicians

Practice addresses (Care Compare)

123 Hospital Dr
Suite 212
Watertown, WI 53098-3336
Phone (920) 471-4044

Hospital & facility affiliations

  • Watertown Memorial Hospital Hospital, Watertown, WI, CCN 520116

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64027-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonheart, Inc. Family Medicine CurrentSince Mar 10, 2023 Accepting new patients
Watertown Family Practice Associates S.C. Family Medicine CurrentSince Mar 1, 2017 Accepting new patients
Weight in Gold Wellness S.C. Family Medicine CurrentSince Apr 4, 2023 Accepting new patients
Watertown Physician Practices LLC Family Medicine Current Accepting new patients
Watertown Physician Practices LLC CurrentSince Sep 1, 2015 Accepting new patients

Locations

540 Village Walk Ln
Ste J
Johnson Creek, WI 53038
Phone (920) 699-4388

1025 Mulberry St
Lake Mills, WI 53551
Phone (920) 261-9591

2501 W Beltline Hwy
Ste 601
Madison, WI 53713
Phone (608) 234-7436

123 Hospital Dr
Ste 212
Watertown, WI 53098
Phone (920) 261-3898

127 Hospital Dr
Watertown, WI 53098
Phone (414) 261-8500

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

N16W23217 Stone Ridge Dr
Ste 350
Waukesha, WI 53188
Phone (844) 206-4930

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20962/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/28527/brand/1/csg/1/fhir/r4
  • Direct secure messaging: leslie.golden.1@28527.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Commonheart HospiceWaukesha, WI, CCN 521578 Hospice Contracted Managing Employee (100%) Jun 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 1

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1336401736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR STE 212",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983336",
            "telephone_number": "920-471-4044",
            "fax_number": "920-471-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HOSPITAL DR STE 212",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983336",
            "telephone_number": "920-471-4044",
            "fax_number": "920-471-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "LESLIE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "64027-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.