Active NPI
Taylor Nicole Leigh, PA-C
- Physician Assistant
- Minneapolis, MN
National Provider Identifier
1013399963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13769
- Practice address
- 1620 W Lake St
Minneapolis, MN 55408-3986 - Phone
- (612) 822-1301
- NPI assigned
- Jun 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13769 | MN | Primary |
Addresses
Primary practice location
1620 W Lake St
Minneapolis, MN 55408-3986
Mailing address
1620 W Lake St
Minneapolis, MN 55408-3986
Phone (612) 822-1301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
23505 Smithtown Rd
Suite 120
Excelsior, MN 55331-4542
Phone (612) 486-4200
779 Bielenberg Dr
Suite 108
Woodbury, MN 55125-4432
Phone (763) 231-8700
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.8 of 100
- Promoting interoperability
- 88
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13769 | MN | MD | Physician Assistant |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1013399963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 W LAKE ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554083986",
"telephone_number": "612-822-1301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 W LAKE ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554083986",
"telephone_number": "612-822-1301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIGH",
"first_name": "TAYLOR",
"middle_name": "NICOLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-26",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.