Individual provider Active NPI

Leslie Tillotson Webster III, MD

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1760468771
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9900719 Issued in NC
Practice address
10650 Park Rd
Ste 480 a
Charlotte, NC 28210-8538
Phone
(704) 355-1813
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9900719 NC Primary

Addresses

Primary practice location

10650 Park Rd
Ste 480 a
Charlotte, NC 28210-8538

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1100 Healing Way
Ste 11A
Matthews, NC 28104-5159
Phone (980) 993-1745

Other practice location 2

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 446-1255

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lwebster237515@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040731000266 NC Practitioner - General Surgery 1355311739 Reassigns benefits to 3 organizations
I20210902000098 SC Practitioner - General Surgery 1355311739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

10650 Park Rd
Suite 480
Charlotte, NC 28210-8538
Phone (704) 667-0520

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)14
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9900719NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center CurrentSince Jul 15, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Surgical Specialists of Charlotte, P.a. Surgery CurrentSince Jan 1, 2009 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 15, 2024 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center CurrentSince Jul 15, 2024 Accepting new patients
Carolinas Physicians Network Inc Surgery CurrentSince Jul 15, 2024 Accepting new patients
Charlotte Trauma Services, PLLC PastSince Jan 1, 2009 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1918 Randolph Rd
Ste 130
Charlotte, NC 28207
Phone (704) 316-6005

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

7300 Carmel Executive Park Dr
Ste 200
Charlotte, NC 28226
Phone (704) 364-8100

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

10650 Park Rd
Ste 480
Charlotte, NC 28210
Phone (704) 355-1813

10512 Park Rd
Ste 101
Charlotte, NC 28210
Phone (704) 339-1076

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

1100 Healing Way
Ste 11A
Matthews, NC 28104
Phone (980) 993-1745

1450 Matthews Township Pkwy
Ste 360
Matthews, NC 28105
Phone (704) 358-0308

1721 Ebenezer Rd
Ste 175
Rock Hill, SC 29732
Phone (803) 324-5256

Interoperability endpoints

  • Direct secure messaging: lwebster237515@carolinashealthcaresystem.direct-ci.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 10

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1760468771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "address_2": "STE 480 A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "704-355-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Healing Way",
            "address_2": "Ste 11A",
            "address_purpose": "LOCATION",
            "city": "Matthews",
            "state": "NC",
            "postal_code": "281045159",
            "country_code": "US",
            "telephone_number": "980-993-1745",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 S Kings Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072134",
            "country_code": "US",
            "telephone_number": "704-446-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "LESLIE",
        "middle_name": "TILLOTSON",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2024-07-15",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "9900719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwebster237515@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10650 Park Rd",
            "address_2": "Ste 480 A",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.