Individual provider Active NPI

Magen Terese Lesak, MD

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1447740964
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S7265 Issued in TX
Practice address
100 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone
(254) 202-2000
Fax
(254) 202-5651
NPI assigned
May 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S7265 TX Primary

Addresses

Primary practice location

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Mailing address

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

Other practice location 1

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlesak330914@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201019000497 TX Practitioner - Family Practice 1254751902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Physician ServicesGroup PAC ID 1153304456, 114 clinicians
Heart of Texas Community Health Center, Inc.Group PAC ID 1153370242, 106 clinicians

Practice addresses (Care Compare)

100 Hillcrest Med Blvde
Waco, TX 76712-8897
Phone (254) 202-2000

140 Hillcrest Medical Blvd
Waco, TX 76712-8897

150 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone (254) 202-4000

1600 Providence Dr
Waco, TX 76707-2261
Phone (254) 313-4200

1800 Gurley LN
Waco, TX 76706-4025
Phone (254) 313-6000

50 Hillcrest Medical Blvd
Waco, TX 76712-8955

50 Hillcrest Medical Blvd
Suite 206
Waco, TX 76712-8954
Phone (254) 202-7950

609 Elm Ave
Waco, TX 76704-2516
Phone (254) 313-6900

Hospital & facility affiliations

  • Alamo Hospice of Waco Hospice, Waco, TX, CCN 671541
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101
  • Ascension Providence Hospital, Waco, TX, CCN 450042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S7265TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Texas Community Health Center, Inc Family Medicine CurrentSince Sep 11, 2020 Accepting new patients
Heart of Texas Community Health Center, Inc. Family Medicine CurrentSince Sep 11, 2020 Accepting new patients
McLennan County Medical Education and Research Foundation Family Medicine Current Accepting new patients
Heart of Texas Community Health Center Inc Current Accepting new patients
Hillcrest Physician Services Family Medicine CurrentSince Aug 4, 2021 Accepting new patients
Hillcrest Baptist Medical Center Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

100 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-2000

1600 Providence Dr
Waco, TX 76707
Phone (254) 313-4200

1800 Gurley Ln
Waco, TX 76706
Phone (254) 313-6000

50 Hillcrest Medical Blvd
Waco, TX 76712
Phone (254) 202-7300

120 Hillcrest Medical Blvd
Ste 300
Waco, TX 76712
Phone (254) 313-6500

609 Elm Ave
Waco, TX 76704
Phone (254) 313-6900

Organizations & group practices 7

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1447740964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 PROVIDENCE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072261",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST MEDICAL BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128897",
            "telephone_number": "254-202-2000",
            "fax_number": "254-202-5651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Providence Dr",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767072261",
            "country_code": "US",
            "telephone_number": "254-313-4200",
            "fax_number": "254-313-4531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESAK",
        "first_name": "MAGEN",
        "middle_name": "TERESE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S7265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlesak330914@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.