Individual provider Active NPI

Leslie Noel Chanasue, M.D.

  • Family Medicine Physician
  • Chesterfield, MO
National Provider Identifier
1831543826
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019031792 Issued in MO
Practice address
17701 Edison Ave Ste 101
Chesterfield, MO 63005
Phone
(636) 735-4122
NPI assigned
Apr 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2019031792 MO Primary

Addresses

Primary practice location

17701 Edison Ave Ste 101
Chesterfield, MO 63005

Mailing address

7532 Hiawatha Ave
Saint Louis, MO 63117-2158
Phone (314) 495-8021

Other practice location 1

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-1358

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
I20190916002674 MO Practitioner - Family Practice 2466743794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

17701 Edison Ave
Suite 101
Chesterfield, MO 63005-1266
Phone (636) 735-4122

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Saint Louis, MO, CCN 267565
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019031792MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Sep 9, 2019 Accepting new patients

Locations

17701 Edison Ave
Ste 101
Chesterfield, MO 63005
Phone (636) 735-4122

621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Interoperability endpoints

  • Direct secure messaging: lchanasue1032419@directc.mercy.net

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.

Hospital & facility affiliations 6

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": "1460764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1831543826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7532 HIAWATHA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631172158",
            "telephone_number": "314-495-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17701 EDISON AVE STE 101",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-735-4122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6019 Walnut Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202113",
            "country_code": "US",
            "telephone_number": "901-226-1358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANASUE",
        "first_name": "LESLIE",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-16",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019031792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.