NPIMap

Individual provider Active NPI

Leslie Susan Cavazos, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Scottsbluff, NE
National Provider Identifier
1629362371
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
31869 Issued in NE
Practice address
3911 Avenue B Ste 2300
Scottsbluff, NE 69361-4617
Phone
(308) 630-1055
Fax
(308) 630-2060
NPI assigned
May 30, 2011
Last updated
Sep 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 31869 NE Primary

Addresses

Primary practice location

3911 Avenue B Ste 2300
Scottsbluff, NE 69361-4617

Mailing address

3911 Avenue B Ste 2300
Scottsbluff, NE 69361-4617
Phone (308) 630-1055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190821002795 NE Practitioner - Physical Medicine and Rehabilitation 0840502878 Reassigns benefits to 1 organization
I20260414002288 CO Practitioner - Physical Medicine and Rehabilitation 0840502878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Iowa, RJ & L Carver College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Regional West Physicians ClinicGroup PAC ID 2062301609, 136 clinicians

Practice addresses (Care Compare)

2315 E Harmony Rd
Suite 110 Uchmg Neurology Redstone
Fort Collins, CO 80528-8623
Phone (970) 482-4373

3911 Ave B
Scottsbluff, NE 69361-4617
Phone (308) 630-2030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.07 of 100Reported as group
Quality
62.54
Promoting interoperability
98
Improvement activities
40
Cost
72.7

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional West Physicians Clinic Physical Medicine & Rehabilitation CurrentSince Aug 19, 2019 Accepting new patients
Panhandle Health Services PastSince Aug 19, 2019 Accepting new patients
Regional West Medical Center Past Accepting new patients
Regional West Medical Center PastSince Aug 19, 2019 Accepting new patients
Regional West Physicians Clinic Past Accepting new patients

Locations

3911 Avenue B
Ste 1100
Scottsbluff, NE 69361
Phone (308) 630-1355

3911 Avenue B
Ste 2300
Scottsbluff, NE 69361
Phone (308) 630-1055

3911 Avenue B
Ste G200
Scottsbluff, NE 69361
Phone (308) 630-1355

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Regional West Medical CenterScottsbluff, NE, CCN 28T061 Hospital W-2 Managing Employee
Operational/Managerial Control		 Aug 19, 2019
Aug 19, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1306713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1629362371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B STE 2300",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-630-1055",
            "fax_number": "308-630-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 AVENUE B STE 2300",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693614617",
            "telephone_number": "308-630-1055",
            "fax_number": "308-630-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVAZOS",
        "first_name": "LESLIE",
        "middle_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-30",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NE",
            "license": "31869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsbluff, NE

Sources for this page

Verify at the official NPI Registry.