LESLIE SHANE GILLIAM MD
NPI 1073580916
Family Medicine in Stephenville, TX

Active since February 28, 2006PECOS Enrolled
205 E FREY ST STE 201, STEPHENVILLE, TX 76401(254) 965-2313(254) 965-2363 Get Directions Write a Review

NPPES record last updated: December 9, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Leslie Shane Gilliam Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LESLIE SHANE GILLIAM MD (NPI 1073580916) is an individual family medicine provider in Stephenville, Texas, licensed in Texas (L7278) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073580916
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameLESLIE SHANE GILLIAMCredential: MD
Location Address205 E FREY ST STE 201Stephenville, TX 76401-2600
Mailing Address205 E Frey St Ste 201Stephenville, TX 76401-2600 · (254) 965-2313 · Fax (254) 965-2363
Fax(254) 965-2363
Sole ProprietorYes
Enumeration DateFebruary 28, 2006
Last NPPES UpdateDecember 9, 2016
NPI 1073580916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in TX · L7278
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

205 E FREY ST STE 201, Stephenville, TX 76401

Other Identifiers 1

Medicare UPINI01752TX

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Leslie Shane Gilliam Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 22, 2014 through January 22, 2026.

Opt-Out Effective DateJanuary 22, 2014
Opt-Out In Effect ThroughJanuary 22, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers14 claims14 services$48.26 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$215.65 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073580916, enumerated as an "individual" on February 28, 2006.

The provider is located at 205 E FREY ST STE 201 STEPHENVILLE, TX 76401 and the phone number is (254) 965-2313.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas,. Please consult your insurance carrier or call the provider to verify.