Leroy A Kamelchuk, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

4438 Issued in AL

Practice address

1107 Gleneagles Dr SW
Huntsville, AL 35801-6405

Phone

(256) 882-3312

Fax

(256) 882-9472

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

University of Alabama School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Maxillofacial Surgery Center of Huntsville, Inc.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Huntsville, AL
  • NPI 1972716710
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1528101698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 GLENEAGLES DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016405",
            "telephone_number": "256-882-3312",
            "fax_number": "256-882-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 GLENEAGLES DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016405",
            "telephone_number": "256-882-3312",
            "fax_number": "256-882-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMELCHUK",
        "first_name": "LEROY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "4438",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "20060",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51527421",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krishna K Kakani, MD
• Marvin S. Kalachman, PA-C, M.S., DFAAPA
• Victoria Louise Kalau, PT, DPT
• Kaleidoscope Therapy, LLC
• Sujatha Kalle
• Kams Transportation and Mobile Health Services
• Rachel Kane, OD
• Maddison Nicole Kaney
• Heejung Victoria Kang, MD
• Mihir Kanitkar, M.D.

• Oral & Maxillofacial Surgery (D.M.D.) in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.