Individual provider Active NPI

Mary Jeannette Leonardi, PA

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1013321876
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05053 Issued in NC
Practice address
3443 Pelham Rd
Suite 200
Greenville, SC 29615-4178
Phone
(864) 254-9330
NPI assigned
Jun 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2125 SC
Physician Assistant 363A00000X 0010-05053 NC Primary

Addresses

Primary practice location

3443 Pelham Rd
Suite 200
Greenville, SC 29615-4178

Mailing address

114 Edinburgh PL
Moore, SC 29369-9667
Phone (864) 431-5775

Other practice location 1

101 E Wood St Ste 401
Spartanburg, SC 29303-3040
Phone (864) 560-6654

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mleonardi179027@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141202000747 SC Practitioner - Physician Assistant 4789906769 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1 Saint Francis Dr
Greenville, SC 29601-3955
Phone (864) 255-1000

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

Hospital & facility affiliations

  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2125SCMDPhysical Therapy Assistant
0010-05053NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC CurrentSince Jul 9, 2024 Accepting new patients
Self Medical Group CurrentSince Sep 27, 2021 Accepting new patients
Self Medical Group CurrentSince Sep 27, 2021 Accepting new patients
Vitalen Inpatient Care, PC CurrentSince Aug 15, 2023 Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 9, 2024 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

75 Remittance Dr
Dept 6764
Chicago, IL 60675

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

125 Commonwealth Dr
Greenville, SC 29615
Phone (864) 225-1800

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1013321876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 EDINBURGH PL",
            "city": "MOORE",
            "state": "SC",
            "postal_code": "293699667",
            "telephone_number": "864-431-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 PELHAM RD",
            "address_2": "SUITE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154178",
            "telephone_number": "864-254-9330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Wood St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293033040",
            "country_code": "US",
            "telephone_number": "864-560-6654",
            "fax_number": "864-560-7353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARDI",
        "first_name": "MARY",
        "middle_name": "JEANNETTE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2125",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mleonardi179027@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mleonardi179027@direct-srhs.et0939.epichosted.com",
            "address_1": "101 E Wood St Ste 401",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293033040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.