Leslie P Smoluch, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD10512 Issued in OR

Practice address

1110 N 18TH St
Suite 3
Springfield, OR 97477-4200

Phone

(541) 726-6447

Fax

(541) 726-7704

NPI assigned

Jun 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891730768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N 18TH ST",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774200",
            "telephone_number": "541-726-6447",
            "fax_number": "541-726-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N 18TH ST",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774200",
            "telephone_number": "541-726-6447",
            "fax_number": "541-726-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLUCH",
        "first_name": "LESLIE",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD10512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184465",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald D Smith, MD
• Ryan Lee Smith, M.D.
• Tony Lavon Smith Jr.
• Valerie Smith, PA-C
• Whitney Kitchell Smith, DDS
• Kiernan Davis Snedigar, QMHA, BA
• Christy Sno, P.A.-C
• Courtney Snow, DPT
• Elizabeth Snow
• Alice So, MD

• Specialist in Springfield, OR
• Providers in Springfield, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.