Benjamin Glen Leavitt, M.D.
Individual provider Active NPI Family Medicine Physician · Aurora, MO
NPI 1629157359 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1629157359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2004016417 (MO)
- Practice address
- 203 S Washington Ave Ste a
Aurora, MO 65605-1466 - Phone
- (417) 678-4022
- Fax
- (417) 678-4025
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Missouri, Columbia School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Hospital Aurora
Mercy Hospital Cassville
Practice addresses (Care Compare)
500 Porter Ave
Aurora, MO 65605-2365
Phone (417) 678-2122
94 Main St
Cassville, MO 65625-1610
Phone (417) 847-6000
Hospital & facility affiliations
- Mercy Hospital Aurora
- Mercy Hospital - Cassville
- Mercy Hospital Springfield
- Mercy Hospital Aurora
- Mercy Hospital - Cassville
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060425000690 | MO | Practitioner - Family Practice |
1850301532 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Hospital Aurora | Current |
Accepting new patients | |
| Mercy Hospital Cassville | Current |
Accepting new patients | |
| Mercy Hospital Cassville | Current |
Accepting new patients | |
| Mercy Hospital Aurora | Current |
Accepting new patients | |
| Paul B Andelin MD PC | Past | Accepting new patients | |
| Medical Partners of Aurora, LLC | Family Medicine | Past | Accepting new patients |
Locations
500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122
94 Main St
Cassville, MO 65625
Phone (417) 782-7722
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2004016417 | MO | Yes |
Addresses
Primary practice location
203 S Washington Ave Ste a
Aurora, MO 65605-1466
Mailing address
600 W Cale St
Monett, MO 65708-2423
Phone (417) 236-9295
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2004016417 | Other | MO | MEDICAL LICENCE NUMBER |
| 8070773 | Other | MO | AAFP I.D. NUMBER |
Other providers in Aurora, MO
- Kingdom Life Counseling LLC
- Jeanette M Kristek
- Ken W Kuschel
- Lawrence County Board for the Developmentally Disabled
- Kelsey Lawrence
- Lester E Cox Medical Centers
- Lester E Cox Medical Centers
- Lifecare Family Services Inc
- Lincare Inc.
- Linda Darlene Long
All providers in Aurora, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.