Leslie Chua Ravago, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME73649 Issued in FL

Practice address

6015 118TH St
Jacksonville, FL 32244-3703

Phone

(904) 633-0610

Fax

(904) 633-0611

NPI assigned

Mar 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lchuaravago59300@direct.shands.ufl.edu

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  Pediatrics

  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Developmental - Behavioral Pediatrics Physician
  • Jacksonville, FL
  • NPI 1649430919
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1487613535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 118TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322443703",
            "telephone_number": "904-633-0610",
            "fax_number": "904-633-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVAGO",
        "first_name": "LESLIE",
        "middle_name": "CHUA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-18",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME73649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2522209-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000760647B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Rauco, DC
• Raul Orta MD PA
• Toni Raulerson, CRTT
• Elizabeth Rauschenberger, MD
• Megan Rauth, M.A. CF-SLP
• Elizabeth J Ravensbergen-Oole, PT
• Malleswari S Ravi, M.D.
• Vidyalatha Ravi
• Nagamanikkam Ravichandran, MD, MBA, FACP
• Sailaja Ravilla, APRN, FNP-C

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.