Leslie Gauntlett, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG003712 Issued in PA

Practice address

180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660

Phone

(215) 554-6222

NPI assigned

Aug 1, 2018

Sex

Female

Sole proprietor

Yes

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 PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Trend Eye Care II LLC

  • Optometrist
  • Philadelphia, PA
  • NPI 1285029223
  Medicare reassignment
• Eyeparlor Inc.

  • Optometrist
  • Brooklyn, NY
  • NPI 1790828366
  NPD (past)

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1871071969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660",
            "telephone_number": "215-554-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUNTLETT",
        "first_name": "LESLIE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "008856",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103831526",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Gaulin, LBS
• Ashley Taylor Gault, DO
• Janice Ann Gault, MD
• Jessica Schiffman Gaulton, MD
• Timothy Glen Gaulton, MD
• Roberta E Gausas, MD
• Harold J. Gauthier, M.D.
• Isabelle Gauthier
• Sandra Gauthier
• Gloryanne Gautier Nieves, MD

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; 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.