LESLIE G TIDWELL MD
NPI 1568419216
Family Medicine in Macon, GA

Q: What is Leslie Tidwell's NPI number?

The NPI number for Leslie Tidwell is 1568419216. It was assigned to this individual provider in the NPPES registry on May 28, 2006.

Q: What is Leslie Tidwell's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Leslie Tidwell was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 28, 2006PECOS Enrolled

3448 VINEVILLE AVE, MACON, GA 31204(478) 405-0045(478) 405-0054 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 17, 2018, Mar 5, 2018 (2 updates tracked since 2018).

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About Leslie G Tidwell Md NPPES

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

LESLIE G TIDWELL MD (NPI 1568419216) is an individual family medicine provider in Macon, Georgia, licensed in Georgia (44359) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1568419216

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameLESLIE G TIDWELLCredential: MD

Location Address3448 VINEVILLE AVEMacon, GA 31204-1867

Mailing Address3448 Vineville AveMacon, GA 31204-1867 · (478) 405-0045 · Fax (478) 405-0054

Phone(478) 405-0045

Fax(478) 405-0054

Sole ProprietorNo

Enumeration DateMay 28, 2006

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1568419216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in GA · 44359

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.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License 44359 (GA)

3448 VINEVILLE AVE, Macon, GA 31204

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Other Identifiers 4

OtherGRP7599GA · Medicare Pin

Medicaid000866907AGA

Medicaid000866907BGA

Other202I169707GA · Medicare Id

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Leslie G Tidwell Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31204 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTA LAUREN KEEN NP

Nurse Practitioner (Family)