Active NPI
Kevin O Leslie, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
National Provider Identifier
1386626257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 23690
- Practice address
- 424 S 56TH St Ste 120
Phoenix, AZ 85034-2108 - Phone
- (602) 685-5211
- Fax
- (602) 685-5325
- NPI assigned
- Nov 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 23690 | AZ | Primary |
Addresses
Primary practice location
424 S 56TH St Ste 120
Phoenix, AZ 85034-2108
Mailing address
PO Box 42210
Phoenix, AZ 85080-2210
Phone (623) 266-7770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 337768 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23690 | AZ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonoran Radiology LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Mesa, AZ
- NPI 1033745708
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596499200000",
"number": "1386626257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 42210",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850802210",
"telephone_number": "623-266-7770",
"fax_number": "623-322-4639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 S 56TH ST STE 120",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850342108",
"telephone_number": "602-685-5211",
"fax_number": "602-685-5325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESLIE",
"first_name": "KEVIN",
"middle_name": "O",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2020-08-04",
"certification_date": "2020-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AZ",
"license": "23690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337768",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.