Individual provider Active NPI

Leslie Ann Deckter, M.D.

  • Psychiatry Physician
  • Mason, OH
National Provider Identifier
1447576301
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.120388 Issued in OH
Practice address
4075 Old Western Row Rd
MLC 2047
Mason, OH 45040-3104
Phone
(513) 536-4673
Fax
(513) 536-0619
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 35.120388 OH Primary

Addresses

Primary practice location

4075 Old Western Row Rd
MLC 2047
Mason, OH 45040-3104

Mailing address

4075 Old Western Row Rd
MLC 2047
Mason, OH 45040-3104
Phone (513) 536-4673

Other identifiers 1

IdentifierTypeStateIssuer
0119954MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150616002716 OH Practitioner - Psychiatry 9739490871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Cincinnati College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lindner Center of Hope Professional AssociatesGroup PAC ID 7012236409, 72 clinicians

Practice addresses (Care Compare)

9435 Waterstone Blvd
Suite 120
Cincinnati, OH 45249-8227
Phone (513) 536-0639

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Craig and Frances Lindner Center of Hope CurrentSince Oct 28, 2024 Accepting new patients
Children'S Hospital Medical Center Past Accepting new patients

Locations

4075 Old Western Row Rd
#2047
Mason, OH 45040
Phone (513) 536-4673

4075 Old Western Row Rd
Mason, OH 45040
Phone (513) 536-0232

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1447576301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "address_2": "MLC 2047",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-4673",
            "fax_number": "513-536-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 OLD WESTERN ROW RD",
            "address_2": "MLC 2047",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403104",
            "telephone_number": "513-536-4673",
            "fax_number": "513-536-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKTER",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.120388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119954",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.