Individual provider Active NPI

Leslie Anthony Crescimano, MD

  • Urology Physician
  • Oakland Park, FL
National Provider Identifier
1508931791
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME0031471 Issued in FL
Practice address
5601 N Dixie Hwy Ste 320
Oakland Park, FL 33334-4146
Phone
(954) 491-0030
Fax
(954) 771-7515
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME0031471 FL Primary

Addresses

Primary practice location

5601 N Dixie Hwy Ste 320
Oakland Park, FL 33334-4146

Mailing address

2160 Colonial Blvd
Fort Myers, FL 33907-1410
Phone (239) 931-7342

Other identifiers 9

IdentifierTypeStateIssuer
048845300MedicaidFL
93617OtherFLBCBS FL
002121500MedicaidFL
1192990OtherFLWELLCARE
4122333OtherFLAETNA ID #
P00471484OtherFLRAILROAD MEDICARE
200963OtherFLAVMED PROVIDER ID #
P0003146OtherFLFLORIDA HEALTHCARE PLUS
10347OtherFLMEDICA HEALTH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080205000683 FL Practitioner - Urology 1153404777 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0031471FLMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC Urology CurrentSince Oct 26, 2007 Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Oct 26, 2007 Accepting new patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients
Genesiscare USA of Florida LLC Urology Past Accepting new patients

Locations

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

2160 Colonial Blvd
Fort Myers, FL 33907

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

Interoperability endpoints

  • Direct secure messaging: leslie.crescimano.1@16705.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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1508931791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 N DIXIE HWY STE 320",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344146",
            "telephone_number": "954-491-0030",
            "fax_number": "954-771-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESCIMANO",
        "first_name": "LESLIE",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME0031471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048845300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "93617",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002121500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "1192990",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID #",
            "identifier": "4122333",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00471484",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED PROVIDER ID #",
            "identifier": "200963",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA HEALTHCARE PLUS",
            "identifier": "P0003146",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH",
            "identifier": "10347",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.