NPIMap

Organization Active NPI

Leslie a. Carter M.D., LLC

  • Dermatology Physician
  • Bend, OR
National Provider Identifier
1962431627
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD25131 Issued in OR
Legal business name
LESLIE A. CARTER M.D., LLC
Practice address
325 SW Upper Terrace Dr.
Suite 100
Bend, OR 97702
Phone
(541) 330-0900
Fax
(541) 312-5739
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Authorized official

Name
Leslie A Carter, M.D.NPI 1730168014
Title
Physician/Owner
Phone
(541) 330-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MD25131 OR Primary

Addresses

Primary practice location

325 SW Upper Terrace Dr.
Suite 100
Bend, OR 97702

Mailing address

325 SW Upper Terrace Dr.
Suite 100
Bend, OR 97702
Phone (541) 330-0900

Other names 1

  • Deschutes Dermatology Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000417 OR Part B Supplier - Clinic/Group Practice 9133188923 Receives reassigned benefits from 3 practitioners
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

325 SW Upper Terrace Dr
Bend, OR 97702

325 SW Upper Terrace Dr
Ste 100
Bend, OR 97702
Phone (541) 330-0900

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1962431627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SW UPPER TERRACE DR.",
            "address_2": "SUITE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-330-0900",
            "fax_number": "541-312-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SW UPPER TERRACE DR.",
            "address_2": "SUITE 100",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97702",
            "telephone_number": "541-330-0900",
            "fax_number": "541-312-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE A. CARTER M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "541-330-0900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OR",
            "license": "MD25131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deschutes Dermatology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.