MRS. LESLIE POLK VAN DYKE (ARNP) – Registered Nurse, NPI 1124023916
Registered Nurse
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,550 NURSE PRACTITIONER in KS
Provider Addresses for MRS. LESLIE POLK VAN DYKE (ARNP)
19836 POST OAK BND
LINDALE, TX 757713621
Phone: (903) 504-3376
Type: Mailing
1846 N CRANBROOK ST
WICHITA, KS 672068916
Phone: (903) 504-3376
Type: Mailing
929 N SAINT FRANCIS AVE
WICHITA, KS 672143821
Phone: (316) 268-5000
Type: Location
1658, West Grande Boulevard, Tyler, Smith County, Texas, 75703, United States
STE 100
TYLER, TX 757034426
Phone: (903) 617-6239
Fax: (903) 617-6249
Type: Location
10512 S 87TH EAST AVE
TULSA, OK 741337067
Phone: (903) 504-3376
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $290.
Total Amount is formed as General ($290) + Research ($0) + Ownership ($0) = $290.
Last reported payment date: 2024-09-11 • Largest payer in this snapshot: Novo Nordisk Inc ($125).
Total Amount
$290
General + Research + Ownership
Payments
8
Total payment records
General Amount
$290
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-11
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-12-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040423000458 | I | Nurse Practitioner | KS | TBD |
| I20141219000063 | I | Nurse Practitioner | OK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75771)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | AZ | |
| - | NC | |
| Internal Medicine | TX | |
| - | TX | |
| Physician Assistant | TX | |
| - | TX | |
| - | LA | |
| Internal Medicine | PA | |
| - | KS | |
| Hospitalist, Internal Medicine | NM |
Reviews
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