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MRS. LESLIE DIANE PUTNAM APRN, FNP-C
NPI 1922550060
Nurse Practitioner - Family in Provo, UT

Active since October 25, 2016PECOS Enrolled
1055 N 500 W STE 205, PROVO, UT 84604(801) 429-8095(801) 354-8265 Get Directions Write a Review

NPPES record last updated: July 22, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 22, 2019, Jan 26, 2017, Oct 25, 2016 (3 updates tracked since 2016).

About Mrs. Leslie Diane Putnam Aprn, Fnp-c NPPES

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

MRS. LESLIE DIANE PUTNAM APRN, FNP-C (NPI 1922550060) is an individual family provider in Provo, Utah, licensed in Utah (217006-4405) and active in the NPI registry since October 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922550060
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. LESLIE DIANE PUTNAMCredential: APRN, FNP-C
Location Address1055 N 500 W STE 205Provo, UT 84604-3305
Mailing Address1905 S Vincent Ridge DrSpanish Fork, UT 84660-8527 · (801) 518-2900
Phone(801) 429-8095
Fax(801) 354-8265
Sole ProprietorNo
Enumeration DateOctober 25, 2016
Last NPPES UpdateJuly 22, 20193 updates tracked since enumeration
✔ NPI 1922550060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 217006-4405
1055 N 500 W STE 205, Provo, UT 84604
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Leslie Diane Putnam Aprn, Fnp-c 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.

Medicare Billing Reassignment

Medicare enrollment records show Leslie Putnam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Apollo Health Centers
30 mi
General Practice
5525 S 900 E, #310
Murray, UT 84117
  • Reassigned Medicare billing, Utah enrollment
  • 5 clinicians in this Medicare group
NPI 1366986721 (801) 685-2862

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84604 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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 2

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

DR. MOHAMMED SOUBHI NIZAM M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1055 N 500 W STE 205
PROVO, UT 84604
Utah County (801) 429-8095
KEVIN JOHNSON MSN, APRN, FNP-C
Nurse Practitioner
1055 N 500 W STE 205
PROVO, UT 84604
Utah County (801) 429-8095

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leslie Putnam's NPI number?

The NPI number for Leslie Putnam is 1922550060. It was assigned to this individual provider in the NPPES registry on October 25, 2016.

Where is Leslie Putnam located?

Leslie Putnam practices at 1055 N 500 W Ste 205, Provo, UT 84604. The listed phone number is (801) 429-8095.

What is Leslie Putnam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Leslie Putnam enrolled in Medicare?

Yes. Leslie Putnam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Leslie Putnam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leslie Putnam reassigns Medicare benefits to Apollo Health Centers (Murray, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Leslie Putnam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Leslie Putnam was last updated on July 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.