Individual provider Active NPI

Brian Louis Lebo, M.D.

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1740307602
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2007038171 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003
Phone
(314) 362-1242
NPI assigned
Mar 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2007038171 MO Primary
Emergency Medicine Physician 207P00000X 2004025521 MO

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Saint Louis, MO 63110-1003

Mailing address

11108 Leisure LN
Saint Louis, MO 63146-5309
Phone (314) 395-0079

Other practice location 1

100 Medical Plz
Lake St Louis, MO 63367-1366
Phone (636) 625-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20080523000538 MO Practitioner - Emergency Medicine 7517036163 Reassigns benefits to 5 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004025521MOMDEmergency Medicine Physician
2007038171MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital South CurrentSince Aug 25, 2019 Accepting new patients
St Louis Pathology Assoc Inc. Current Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospital South Emergency Medicine CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospital Jefferson CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jul 1, 2019 Accepting new patients
SSM Health Care St. Louis Emergency Medicine Past Accepting new patients
SSM Health Care St. Louis Past Accepting new patients

Locations

1400 US Highway 61
Crystal Cty, MO 63028
Phone (636) 933-1111

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

Organizations & group practices 12

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": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1740307602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11108 LEISURE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465309",
            "telephone_number": "314-395-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-1242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Lake St Louis",
            "state": "MO",
            "postal_code": "633671366",
            "country_code": "US",
            "telephone_number": "636-625-5200",
            "fax_number": "636-625-5314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBO",
        "first_name": "BRIAN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2007038171",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2004025521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.