NPIMap

Individual provider Active NPI

Leslie Fegenbush Smith, D.O.

  • Emergency Medicine Physician
  • Louisville, KY
National Provider Identifier
1598968935
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
03141 Issued in KY
Practice address
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone
(502) 636-7225
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 03141 KY Primary

Addresses

Primary practice location

1 Audubon Plaza Dr
Louisville, KY 40217-1318

Mailing address

PO Box 776351
Chicago, IL 60677-6218
Phone (502) 559-9337

Other identifiers 2

IdentifierTypeStateIssuer
710066040MedicaidKY
200919590MedicaidIN

Other names 1

  • Miss Leslie Elaine Fegenbush Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081212000664 KY Practitioner - Emergency Medicine 9537252408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03141KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Community Medical Associates, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Jane Todd Crawford Memorial Hospital, Inc. Emergency Medicine CurrentSince Mar 2, 2010 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Breckinridge Health, Inc. Emergency Medicine Past Accepting new patients

Locations

290 Industrial Park Rd
Greensburg, KY 42743
Phone (270) 634-1921

310 Industrial Park Rd
Greensburg, KY 42743
Phone (270) 299-2286

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

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 and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1598968935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776218",
            "telephone_number": "502-559-9337",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-636-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LESLIE",
        "middle_name": "FEGENBUSH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "03141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710066040",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200919590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "FEGENBUSH",
            "middle_name": "ELAINE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.