Individual provider Active NPI

Leslie Lukert, FNP-C

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1457113995
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024187793 Issued in VA
Practice address
1011 N Macdill Ave
Tampa, FL 33607-5126
Phone
(813) 876-0625
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024187793 VA Primary

Addresses

Primary practice location

1011 N Macdill Ave
Tampa, FL 33607-5126

Mailing address

2335 40TH St NW Apt 2
Washington, DC 20007-1757
Phone (301) 461-9774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241202000898 VA Practitioner - Nurse Practitioner 3476088329 Reassigns benefits to 1 organization
I20250210000951 DC Practitioner - Nurse Practitioner 3476088329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

3903 Fair Ridge Dr
Suite 219
Fairfax, VA 22033-2945
Phone (703) 865-6490

4820 31St St S
Suite B
Arlington, VA 22206-1665
Phone (703) 865-6490

8130 Boone Blvd
Suite 110
Vienna, VA 22182-2640
Phone (571) 982-6636

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024187793VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Oct 14, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Oct 14, 2024 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Life Extension Clinics, Inc PastSince Feb 4, 2024 Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

4820 31st St S
Ste B
Arlington, VA 22206
Phone (703) 865-6542

3903 Fair Ridge Dr
Ste 209
Fairfax, VA 22033
Phone (571) 349-2191

8644 Sudley Rd
#220
Manassas, VA 20110

8130 Boone Blvd
Ste 110
Vienna, VA 22182
Phone (703) 362-4260

14010 Smoketown Rd
Ste 105
Woodbridge, VA 22192
Phone (703) 730-4848

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: leslie.lukert.1@8042.direct.athenahealth.com

Organizations & group practices 4

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": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1457113995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 40TH ST NW APT 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200071757",
            "telephone_number": "301-461-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N MACDILL AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075126",
            "telephone_number": "813-876-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKERT",
        "first_name": "LESLIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024187793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.