Individual provider Active NPI

Leah Maynard, PA-C

  • Physician Assistant
  • Williamsville, NY
National Provider Identifier
1013640564
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5530 Sheridan Dr Ste 2
Williamsville, NY 14221-3730
Phone
(716) 565-1978
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5530 Sheridan Dr Ste 2
Williamsville, NY 14221-3730

Mailing address

4482 Peet St
Middleport, NY 14105-9609
Phone (716) 255-0523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220901003050 NY Practitioner - Physician Assistant 3779967104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Cardiology PCGroup PAC ID 5496771164, 8 clinicians

Practice addresses (Care Compare)

5530 Sheridan Dr
Suite 2
Williamsville, NY 14221-3730
Phone (716) 565-1978

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028655NYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Physicians, P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lvandenbosch@subcard.medentdirect.com

Organizations & group practices 2

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 9

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": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1013640564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4482 PEET ST",
            "city": "MIDDLEPORT",
            "state": "NY",
            "postal_code": "141059609",
            "telephone_number": "716-255-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 SHERIDAN DR STE 2",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213730",
            "telephone_number": "716-565-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "LEAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.