Individual provider Active NPI

Leonardo Rauch, PA-C

  • Physician Assistant
  • Tulsa, OK
National Provider Identifier
1730124595
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1733 Issued in OK
Practice address
1705 E 19TH St
Ste 302
Tulsa, OK 74104-5405
Phone
(918) 748-7692
Fax
(918) 748-7539
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1733 OK Primary

Addresses

Primary practice location

1705 E 19TH St
Ste 302
Tulsa, OK 74104-5405

Mailing address

1515 N Harvard Ave
Ste E
Tulsa, OK 74115-4957
Phone (918) 832-6049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000395 OK Practitioner - Physician Assistant 7113902982 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

5200 E I 240 Service Rd
Suite 330
Oklahoma City, OK 73135-2607
Phone (405) 755-4290

Merit-based Incentive Payment System (MIPS)

Final score
73.31 of 100Reported as group
Improvement activities
20
Cost
82.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1733OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc. CurrentSince Feb 22, 2011 Accepting new patients
St. John Physicians, Inc CurrentSince Feb 22, 2011 Accepting new patients
Post Acute Physicians, LLC CurrentSince Aug 10, 2025 Accepting new patients
Lester E Cox Medical Centers PastSince Jan 1, 1990 Accepting new patients
Pulmonary Specialists L L C PastSince Jul 12, 2017 Accepting new patients

Locations

1000 W Boise Cir
Fl 3
Broken Arrow, OK 74012
Phone (918) 682-6161

1515 N Harvard Ave
Ste E
Tulsa, OK 74115
Phone (918) 832-6049

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Interoperability endpoints

  • Direct secure messaging: leonardo.rauch@direct.stjohnhealthsystem.com

Organizations & group practices 8

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1730124595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N HARVARD AVE",
            "address_2": "STE E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741154957",
            "telephone_number": "918-832-6049",
            "fax_number": "918-832-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 E 19TH ST",
            "address_2": "STE 302",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045405",
            "telephone_number": "918-748-7692",
            "fax_number": "918-748-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUCH",
        "first_name": "LEONARDO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.