Individual provider Active NPI

Leslie Stephen Mentel, L.AC.

  • Acupuncturist
  • Fairport, NY
National Provider Identifier
1669512448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
001964-1 Issued in NY
Practice address
7700 Pittsford Palmyra Rd
Fairport, NY 14450-9590
Phone
(585) 317-6725
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 001964-1 NY Primary
Acupuncturist 171100000X 212673 MA

Addresses

Primary practice location

7700 Pittsford Palmyra Rd
Fairport, NY 14450-9590

Mailing address

230 Yarmouth Rd
Rochester, NY 14610-1454
Phone (585) 317-6725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
001964-1NYMDArt Therapist
212673MAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669512448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 YARMOUTH RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146101454",
            "telephone_number": "585-317-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 PITTSFORD PALMYRA RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144509590",
            "telephone_number": "585-317-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTEL",
        "first_name": "LESLIE",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "001964-1",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MA",
            "license": "212673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.