Individual provider Active NPI

Bruce W Leslie, M.D.

  • Internal Medicine Physician
  • Petersburg, WV
National Provider Identifier
1457455958
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14236 Issued in WV
Practice address
Grant Memorial Drive
Pidc Building - Suite 102
Petersburg, WV 26847-1716
Phone
(304) 257-2527
NPI assigned
Sep 13, 2006
Last updated
Mar 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14236 WV Primary

Addresses

Primary practice location

Grant Memorial Drive
Pidc Building - Suite 102
Petersburg, WV 26847-1716

Mailing address

PO Box 158
Petersburg, WV 26847-0158
Phone (304) 257-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20120202000634 WV Practitioner - Internal Medicine 2163689175 Reassigns benefits to 3 organizations
Practice locations: Petersburg, WV

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Memorial Hospital Inc CurrentSince Jul 3, 2023 Accepting new patients
South Branch Hospitalist and Internal Medicine Group PLLC Internal Medicine CurrentSince Feb 1, 2018 Accepting new patients
Grant Memorial Hospital Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Grant Memorial Hospital Current Accepting new patients
Grant Memorial Hospital Inc CurrentSince Jul 3, 2023 Accepting new patients
Grant Memorial Hospital CurrentSince Sep 1, 2019 Accepting new patients

Locations

117 Hospital Dr
Petersburg, WV 26847
Phone 30497450009312

65 Hospital Dr
#102
Petersburg, WV 26847
Phone (304) 257-2527

65 Hospital Dr
Ste 102
Petersburg, WV 26847
Phone (304) 257-2527

Interoperability endpoints

  • Direct secure messaging: phys_bruce_w_leslie@yourcarecommunity.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1457455958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268470158",
            "telephone_number": "304-257-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRANT MEMORIAL DRIVE",
            "address_2": "PIDC BUILDING - SUITE 102",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471716",
            "telephone_number": "304-257-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "BRUCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "14236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, WV

Sources for this page

Verify at the official NPI Registry.