Individual provider Active NPI

Leslie Marie Greenlee, D.O.

  • Pediatrics Physician
  • Cedar Rapids, IA
National Provider Identifier
1700105780
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4417 Issued in IA
Practice address
855 A Ave NE
Cedar Rapids, IA 52402-5057
Phone
(319) 368-9301
NPI assigned
May 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4417 IA Primary

Addresses

Primary practice location

855 A Ave NE
Cedar Rapids, IA 52402-5057

Mailing address

855 A Ave NE
Cedar Rapids, IA 52402-5057
Phone (319) 431-8011

Other identifiers 1

IdentifierTypeStateIssuer
1700105780MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131001000285 IA Practitioner - Pediatric Medicine 5496989691 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4417IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital CurrentSince Jan 1, 2015 Accepting new patients
St. Luke'S Methodist Hospital CurrentSince Jan 1, 2015 Accepting new patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince Oct 5, 2014 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Oct 5, 2014 Accepting new patients
Trinity Regional Medical Center Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

1026 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 369-5970

202 10th St SE
Ste 285
Cedar Rapids, IA 52403
Phone (319) 369-7816

855 A Ave NE
Ste 400
Cedar Rapids, IA 52402
Phone (319) 363-3565

855 A Ave NE
Ste 300
Cedar Rapids, IA 52402
Phone (319) 368-9300

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

Interoperability endpoints

  • Direct secure messaging: lgreenlee44391@direct.unitypoint.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1275264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1700105780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-431-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 A AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025057",
            "telephone_number": "319-368-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "LESLIE",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-31",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "4417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700105780",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.