Active NPI
Leslie Capulong, MD
- Psychiatry Physician
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 325281
- Practice address
- 415 E Madison St
South Bend, IN 46617-2322 - Phone
- (574) 283-1234
- NPI assigned
- Mar 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01096917A | IN | |
| Psychiatry Physician | 2084P0800X | 325281 | NY | Primary |
Addresses
Primary practice location
415 E Madison St
South Bend, IN 46617-2322
Mailing address
5776 Grape Rd Ste 51
PMB 190
Mishawaka, IN 46545-8460
Phone (347) 504-0301
Other practice location 1
224 W 35th St Ste 500
#3595
New York, NY 10001-2538
Phone (347) 504-0301
Other practice location 2
2600 Oakland Ave
Elkhart, IN 46517-1533
Phone (574) 533-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
415 E Madison St
South Bend, IN 46617-2322
Phone (574) 283-1234
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01096917A | IN | MD | Psychiatry Physician |
| 325281 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oaklawn Psychiatric Center, Inc. | Current | Accepting new patients | |
| Oaklawn Psychiatric Center, Inc. | Current | Accepting new patients |
Locations
2600 Oakland Ave
Elkhart, IN 46517
Phone 5745331234 ext. 488
330 Lakeview Dr
Goshen, IN 46528
Phone (219) 533-1234
415 E Madison St
South Bend, IN 46617
Phone (574) 283-1234
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Elkhart, IN
- NPI 1598847212
-
- Psychiatric Hospital
- Goshen, IN
- NPI 1467407395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1346877644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5776 GRAPE RD STE 51",
"address_2": "PMB 190",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465458460",
"telephone_number": "347-504-0301",
"fax_number": "201-733-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 E MADISON ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172322",
"telephone_number": "574-283-1234"
}
],
"practiceLocations": [
{
"address_1": "224 W 35th St Ste 500",
"address_2": "#3595",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100012538",
"country_code": "US",
"telephone_number": "347-504-0301",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2600 Oakland Ave",
"address_purpose": "LOCATION",
"city": "Elkhart",
"state": "IN",
"postal_code": "465171533",
"country_code": "US",
"telephone_number": "574-533-1234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAPULONG",
"first_name": "LESLIE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-25",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01096917A",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "325281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.