Individual provider Active NPI

Leslie Kinder, OD

  • Optometrist
  • Maryland Heights, MO
National Provider Identifier
1790345429
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2019021310 Issued in MO
Practice address
2311 McKelvey Rd
Maryland Heights, MO 63043-1531
Phone
(314) 434-9450
Fax
(314) 434-0151
NPI assigned
Jun 14, 2019
Last updated
Apr 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2131 SC
Optometrist 152W00000X 2019021310 MO Primary

Addresses

Primary practice location

2311 McKelvey Rd
Maryland Heights, MO 63043-1531

Mailing address

2311 McKelvey Rd
Maryland Heights, MO 63043-1531
Phone (314) 434-9450

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201009001150 MO Practitioner - Optometry 1153741327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nucrown, LLCGroup PAC ID 1456256346, 22 clinicians

Practice addresses (Care Compare)

10867 W Florissant Ave
Crown Vision Ctr
Saint Louis, MO 63136-2405
Phone (314) 817-5367

4145 Lindell Blvd
Saint Louis, MO 63108-2913
Phone (314) 533-1898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2131SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Browning Corrections Optometry LLC CurrentSince Sep 1, 2020 Accepting new patients
Nucrown,Inc. Optometrist CurrentSince Jan 1, 2023 Accepting new patients
Nu-Crown, LLC Optometrist CurrentSince Jan 1, 2023 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

2311 McKelvey Rd
Maryland Heights, MO 63043
Phone (314) 434-9450

10867 West Florissant Ave
Saint Louis, MO 63136
Phone (314) 817-5367

4145 Lindell Blvd
Saint Louis, MO 63108
Phone (314) 533-1898

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1790345429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 MCKELVEY RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630431531",
            "telephone_number": "314-434-9450",
            "fax_number": "314-434-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 MCKELVEY RD",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630431531",
            "telephone_number": "314-434-9450",
            "fax_number": "314-434-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINDER",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2131",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019021310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryland Heights, MO

Sources for this page

Verify at the official NPI Registry.