Kelly Leaf, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD22901 Issued in OR

Practice address

24800 SE Stark St
Emergency Department
Gresham, OR 97030-3378

Phone

(503) 674-1122

NPI assigned

Apr 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency MedicineAlso: Family Practice

Education

Loma Linda University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: kelly.leaf@ouc-or.direct.office.nextgen.com

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.

• One-Stop Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Beaverton, OR
  • NPI 1982008025
  Medicare reassignment NPD Authorized official
• Cep America LLC

  • Emergency Medicine Physician
  • Roseburg, OR
  • NPI 1780647719
  NPD (past)
• Cep America LLC

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1447484274
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1023071016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-674-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24800 SE STARK ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303378",
            "telephone_number": "503-674-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAF",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD22901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "202438",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8370835",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287166",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC/BS",
            "identifier": "858543006",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lawry, CCC-SLP
• Robert Lay, L.M.T
• Lam L Le, MD
• Nhat Quang Le, FNP-BC
• Thuy-Duong Le, PHARM.D
• Daniel Leake, LMT
• Kathleen Suzanne Leavitt, M.ED.
• Korina Leclerc, LCSW
• Anna Lee, PAC
• Danielle Cherie Lee, LE

• Emergency Medicine Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.

Verify at the official NPI Registry.