NPIMap

Individual provider Active NPI

Nicolo Leyeza Cabrera, MD

  • Infectious Disease Physician
  • Saint Louis, MO
National Provider Identifier
1366858797
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
2021000356 Issued in MO
Practice address
12634 Olive Blvd
Div Im Infectious Disease
Saint Louis, MO 63141-6337
Phone
(314) 996-8000
Fax
(314) 362-9851
NPI assigned
Jul 7, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2021000356 MO
Infectious Disease Physician 207RI0200X 2021000356 MO Primary

Addresses

Primary practice location

12634 Olive Blvd
Div Im Infectious Disease
Saint Louis, MO 63141-6337

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 996-8000

Other identifiers 1

IdentifierTypeStateIssuer
200098915MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210819001463 MO Practitioner - Infectious DiseasePractitioner - Internal Medicine 7719284314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1 Barnes Jew Hosp PLZ
Saint Louis, MO 63110-1003
Phone (314) 747-3000

1020 N Mason Rd
Saint Louis, MO 63141-6300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

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.

Hospital & facility affiliations 3

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1366858797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-996-8000",
            "fax_number": "314-362-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12634 OLIVE BLVD",
            "address_2": "DIV IM INFECTIOUS DISEASE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416337",
            "telephone_number": "314-996-8000",
            "fax_number": "314-362-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRERA",
        "first_name": "NICOLO",
        "middle_name": "LEYEZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-07",
        "last_updated": "2025-04-15",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2021000356",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2021000356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200098915",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "12634 Olive Blvd",
            "address_2": "Div IM Infectious Disease",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.