Lesley Vaughn Landis, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

25842 Issued in OK

Practice address

2005 E 21St St Ste 350
Tulsa, OK 74114-1403

Phone

(918) 764-8516

Fax

(918) 764-8514

NPI assigned

Jun 28, 2007

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lesley.landis@direct.stjohnhealthsystem.com

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.

• Lesley V Landis MD PLLC

  dba Landis Plastic Surgery

  • Plastic Surgery Physician
  • Tulsa, OK
  • NPI 1679287767
  Medicare reassignment NPD Authorized official
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406

  Plastic Surgery

  Medicare reassignment NPD
• St. John Physicians, Inc

  dba Siggins Memorial Clinic

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD
• St John Cardiovasuclar Services Inc

  • Cardiovascular Disease Physician
  • Tulsa, OK
  • NPI 1952343451
  NPD (past)

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1851598320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 E 21ST ST STE 350",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141403",
            "telephone_number": "918-764-8516",
            "fax_number": "918-764-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 E 21ST ST STE 350",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741141403",
            "telephone_number": "918-764-8516",
            "fax_number": "918-764-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "LESLEY",
        "middle_name": "VAUGHN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "25842",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OK",
            "license": "25842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200173290A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael D Landers, DO
• Steven Landgarten, MD
• Alesia Landis, RN
• Amanda Lynn Landis
• Damon Landis
• Mariah Landis
• Landmark Recovery Outpatient Services, LLC (Landmark Recovery of Tulsa Outpatient Services)
• Kathryn Anne Landreneau, APRN, FNP-BC
• Barbara Jean Landreth, APRN-CNP
• Kylie Landrigan

• Plastic Surgery Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Plastic Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.