Active NPI
Chad Leblanc, DO
- Emergency Medical Services (Emergency Medicine) Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 58708721204
- Practice address
- 1034 North 500 West
Provo, UT 84604 - Phone
- (801) 373-7850
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 58708721204 | UT | Primary |
Addresses
Primary practice location
1034 North 500 West
Provo, UT 84604
Mailing address
PO Box 10
Spanish Fork, UT 84660-0010
Phone (866) 898-7136
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58708721200001 | Other | BCBS | |
| 58708721202001 | Other | UT | BCBS |
| P00295439 | Other | RAILROAD MEDICARE | |
| P00420439 | Other | UT | RAIL ROAD MEDICARE |
| 1588604532 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
170 N 1100
American Fork, UT 84003-2096
Phone (801) 714-6570
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58708721204 | UT | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Valley Emergency Physicians LC | Emergency Medical Services | Current | Accepting new patients |
| Utah Valley Emergency Physicians Inc | Emergency Medicine | Current | Accepting new patients |
Locations
170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570
331 N 400 W
Orem, UT 84057
Phone (801) 224-4080
1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119
Organizations & group practices 2
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.
-
- Emergency Medical Services (Emergency Medicine) Physician
- American Fork, UT
- NPI 1134177876
-
- Emergency Medicine Physician
- Provo, UT
- NPI 1649204553
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Utah Valley Hospital
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
dba Intermountain Health Infusion Center- Spanish Fork, A Service of Utah Valley Hospital
- Infusion Therapy Clinic/Center
- Spanish Fork, UT
- NPI 1679426944
Hospital
-
dba Intermountain Health American Fork Hospital
- General Acute Care Hospital
- American Fork, UT
- NPI 1912014358
-
dba Intermountain Health Infusion Center- American Fork, A Service of Utah Valley Hospital
- Infusion Therapy Clinic/Center
- American Fork, UT
- NPI 1982557252
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1588604532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846600010",
"telephone_number": "866-898-7136",
"fax_number": "616-975-9824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1034 NORTH 500 WEST",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-373-7850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBLANC",
"first_name": "CHAD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "UT",
"license": "58708721204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "58708721200001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "58708721202001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00295439",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "P00420439",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1588604532",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.