Active NPI
Leslie E Tucker, M.D.
- Gastroenterology Physician
- Washington, MO
National Provider Identifier
1699718643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- R5740
- Practice address
- 901 Patients First Dr
Washington, MO 63090-4700 - Phone
- (636) 239-7344
- Fax
- (636) 239-9436
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | R5740 | MO | Primary |
Addresses
Primary practice location
901 Patients First Dr
Washington, MO 63090-4700
Mailing address
901 Patients First Dr
Washington, MO 63090-4700
Phone (636) 239-7344
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100013863 | Other | RAILROAD MEDICARE | |
| 200991511 | Medicaid | MO |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R5740 | MO | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Patients First Health Care LLC | Gastroenterology | Current | Accepting new patients |
Locations
1015 Bowles Ave
Ste 1000
Fenton, MO 63026
Phone (636) 390-1400
9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100
901 Patients First Dr
Washington, MO 63090
Phone (636) 239-7500
Interoperability endpoints
- ltucker77040@directc.mercy.net
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Washington, MO
- NPI 1962441386
Gastroenterology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327276800000",
"number": "1699718643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 PATIENTS FIRST DR",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630904700",
"telephone_number": "636-239-7344",
"fax_number": "636-239-9436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 PATIENTS FIRST DR",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "630904700",
"telephone_number": "636-239-7344",
"fax_number": "636-239-9436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "LESLIE",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2012-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MO",
"license": "R5740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "100013863",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200991511",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Washington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.