Individual provider Active NPI

Erica Nichole Leclair, MD

  • Neonatal-Perinatal Medicine Physician
  • Waterloo, IA
National Provider Identifier
1710145115
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
39619 Issued in IA
Practice address
3421 W 9TH St
Waterloo, IA 50702-5401
Phone
(319) 272-8422
Fax
(319) 272-8203
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39619 IA
Neonatal-Perinatal Medicine Physician 2080N0001X MD-39619 IA
Neonatal-Perinatal Medicine Physician 2080N0001X 39619 IA Primary

Addresses

Primary practice location

3421 W 9TH St
Waterloo, IA 50702-5401

Mailing address

3421 W 9TH St
Waterloo, IA 50702-5401
Phone (319) 272-8422

Other practice location 1

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-8422

Other practice location 2

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-8422

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
I20140509001777 IA Practitioner - Pediatric Medicine 2860630894 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: eleclair3933914@direct.trinity-health.org

Organizations & group practices 2

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1710145115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8422",
            "fax_number": "319-272-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 W 9TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025401",
            "telephone_number": "319-272-8422",
            "fax_number": "319-272-8203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3421 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "50702",
            "country_code": "US",
            "telephone_number": "319-272-8422",
            "fax_number": "319-272-8203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3421 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "50702",
            "country_code": "US",
            "telephone_number": "319-272-8422",
            "fax_number": "319-272-8203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LECLAIR",
        "first_name": "ERICA",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "39619",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IA",
            "license": "MD-39619",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IA",
            "license": "39619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.