NPIMap

Individual provider Active NPI

Thomas Anthony Lebeau, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
National Provider Identifier
1659587897
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3385 Issued in FL
Practice address
1 Saint Johns Medical Park Dr
St Augustine, FL 32086-5300
Phone
(904) 824-0869
Fax
(904) 826-0966
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901001508 MI
Foot & Ankle Surgery Podiatrist 213ES0103X PO3385 FL Primary

Addresses

Primary practice location

1 Saint Johns Medical Park Dr
St Augustine, FL 32086-5300

Mailing address

1 Saint Johns Medical Park Dr
St Augustine, FL 32086-5300
Phone (904) 824-0869

Other identifiers 4

IdentifierTypeStateIssuer
5184027MedicaidMI
480F37288OtherMIBLUE CROSS/BLUE SHIELD
P00408087OtherMIRAILROAD MEDICARE
001262300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20091116000565 FL Practitioner - Podiatry 2466366406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Johns Medical Park Dr
Saint Augustine, FL 32086-5300
Phone (904) 824-0869

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as apm
Quality
77.66
Promoting interoperability
70.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal129
Removal of tissue135
Removal of skin lesions42
Removal of nail tissue850
Removal or shaving of skin growth141
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3385FLMDFoot & Ankle Surgery Podiatrist
5901001508MIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Augustine Foot & Ankle, Inc Foot & Ankle Surgery CurrentSince Oct 1, 2009 Accepting new patients
St. Augustine Foot & Ankle, Inc CurrentSince Oct 1, 2009 Accepting new patients
Thomas a Lebeau DPM PC PastSince Oct 20, 2008 Accepting new patients
Labaza Eyecare, P.C. Past Accepting new patients
St. Augustine Foot & Ankle, Inc. Past Accepting new patients

Locations

1 Saint Johns Medical Park Dr
St Augustine, FL 32086
Phone (904) 797-1958

Interoperability endpoints

  • Direct secure messaging: tlebeau743524@direct.shands.ufl.edu

Organizations & group practices 5

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1659587897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT JOHNS MEDICAL PARK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865300",
            "telephone_number": "904-824-0869",
            "fax_number": "904-826-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT JOHNS MEDICAL PARK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865300",
            "telephone_number": "904-824-0869",
            "fax_number": "904-826-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEAU",
        "first_name": "THOMAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001508",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5184027",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "480F37288",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00408087",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001262300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.