Individual provider Active NPI

David Alan Leitman II, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Saint Louis, MO
National Provider Identifier
1427378298
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone
(314) 653-5000
NPI assigned
Jun 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

11133 Dunn Rd
Saint Louis, MO 63136-6163

Mailing address

896 Cypress TRL
O Fallon, MO 63368-8297
Phone (636) 485-6964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20200204002511 MO Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 2961750898 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2010
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)

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone 31436272001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Miracl, LLC CurrentSince May 15, 2020 Accepting new patients
Washington University CurrentSince May 15, 2020 Accepting new patients
Missouri Delta Medical Center CurrentSince Jan 6, 2020 Accepting new patients
BJC Outpatient Imaging LLC CurrentSince Feb 1, 2026 Accepting new patients
Missouri Delta Medical Center CurrentSince Jan 6, 2020 Accepting new patients

Locations

1785 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 681-1540

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

510 S Kingshighway Blvd
#8131
Saint Louis, MO 63110
Phone (314) 362-2900

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

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 7

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1427378298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 CYPRESS TRL",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688297",
            "telephone_number": "636-485-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "314-653-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITMAN",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.