Dr Leslie M Dally, DO is a medicare enrolled "Preventive Medicine - Addiction Medicine" physician in Bowling Green, Kentucky. He went to Kansas City College Of Medicine And Surgery and graduated in 2002 and has 23 years of diverse experience with area of expertise as Addiction Medicine. He is a member of the group practice Cleanslate Medical Group Of Kentucky Pllc, Specialistsmat Psc and his current practice location is
944 Searcy Way, Bowling Green, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 467-7180.
Dr Leslie M Dally is licensed to practice in Kentucky (license number 03348) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1306093877.
Physician's Profile
| Full Name | Dr Leslie M Dally |
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| Gender | Male |
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| Speciality | Addiction Medicine |
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| Experience | 23 Years |
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| Location | 944 Searcy Way, Bowling Green, Kentucky |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Leslie M Dally attended and graduated from Kansas City College Of Medicine And Surgery in 2002
NPI Data:
- NPI Number: 1306093877
- Provider Enumeration Date: 08/26/2008
- Last Update Date: 01/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 0244399160
- Enrollment ID: I20110726000601
Medical Identifiers
Medical identifiers for Dr Leslie M Dally such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306093877 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083A0300X | Preventive Medicine - Addiction Medicine | 03348 (Kentucky) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Cleanslate Medical Group Of Kentucky Pllc | 4486909769 | 18 |
| Specialistsmat Psc | 7810307634 | 4 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Leslie M Dally allows following entities to bill medicare on his behalf.
| Entity Name | Cleanslate Medical Group Of Kentucky Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538600630
PECOS PAC ID: 4486909769
Enrollment ID: O20180611002156 |
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| Entity Name | Specialistsmat Psc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851998181
PECOS PAC ID: 7810307634
Enrollment ID: O20201106001396 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Leslie M Dally is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Leslie M Dally, DO
944 Searcy Way,
Bowling Green, KY 42103-7168
Ph: (270) 467-7180 | Dr Leslie M Dally, DO
944 Searcy Way,
Bowling Green, KY 42103-7168
Ph: (270) 467-7180 |
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