Individual provider Active NPI

Leslie Adinah Nurse, M.D.

  • Otolaryngology Physician
  • Upper Marlboro, MD
National Provider Identifier
1366619231
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D659549 Issued in MD
Practice address
1221 Mercantile Lane
Kaiser Permanente Largo Medical Center
Upper Marlboro, MD 20774
Phone
(917) 992-1060
Fax
(301) 618-5571
NPI assigned
May 10, 2008
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 0101245996 VA
Otolaryngology Physician 207Y00000X 43532 TN
Otolaryngology Physician 207Y00000X MD038301 DC
Otolaryngology Physician 207Y00000X D659549 MD Primary

Addresses

Primary practice location

1221 Mercantile Lane
Kaiser Permanente Largo Medical Center
Upper Marlboro, MD 20774

Mailing address

5109 Dudley LN
Apt 304
Bethesda, MD 20814-5450
Phone (917) 992-1060

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090917000561 DC Practitioner - Otolaryngology 2062586548 Reassigns benefits to 5 organizations
I20150417000763 MD Practitioner - Otolaryngology 2062586548 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
New York University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

10810 Connecticut Ave
Kensington, MD 20895-2138
Phone (301) 929-7100

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

2391 Greenspring Dr
Timonium, MD 21093-6038
Phone (301) 816-2424

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D659549MDMDOtolaryngology Physician
0101245996VAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 14, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 1, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jul 7, 2014 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 14, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 2, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince May 2, 2020 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 2, 2009 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 25, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Aug 2, 2009 Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

Organizations & group practices 10

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 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": "1210377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1366619231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 DUDLEY LN",
            "address_2": "APT 304",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208145450",
            "telephone_number": "917-992-1060",
            "fax_number": "301-618-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LANE",
            "address_2": "KAISER PERMANENTE LARGO MEDICAL CENTER",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20774",
            "telephone_number": "917-992-1060",
            "fax_number": "301-618-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURSE",
        "first_name": "LESLIE",
        "middle_name": "ADINAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-10",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VA",
            "license": "0101245996",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TN",
            "license": "43532",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "DC",
            "license": "MD038301",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D659549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1221 Mercantile Lane",
            "address_2": "Kaiser Permanente Largo Medical Center",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

Verify at the official NPI Registry.