Individual provider Active NPI

Leslie D Koberstein, NP

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1629555727
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024176309 Issued in VA
Practice address
11835 Fishing Point Dr Ste 104
Newport News, VA 23606-2584
Phone
(757) 246-3146
NPI assigned
Jul 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11963220-4405 UT
Family Nurse Practitioner 363LF0000X 0024176309 VA Primary

Addresses

Primary practice location

11835 Fishing Point Dr Ste 104
Newport News, VA 23606-2584

Mailing address

11835 Fishing Point Dr Ste 104
Newport News, VA 23606-2584
Phone (757) 246-3146

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210420000131 UT Practitioner - Nurse Practitioner 0941550420 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc. CurrentSince Jun 13, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 11, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jun 11, 2023 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Mar 13, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Mar 13, 2021 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Interoperability endpoints

  • Direct secure messaging: leslie.koberstein@voa.ikm.direct-ci.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1629555727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 FISHING POINT DR STE 104",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062584",
            "telephone_number": "757-246-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 FISHING POINT DR STE 104",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062584",
            "telephone_number": "757-246-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBERSTEIN",
        "first_name": "LESLIE",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-23",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11963220-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024176309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.