Individual provider Active NPI

Gregory David Leder, PA

  • Surgical Physician Assistant
  • Albany, NY
National Provider Identifier
1033463930
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
019604 Issued in NY
Practice address
121 Everett Rd
Albany, NY 12205-1474
Phone
(518) 489-2663
Fax
(518) 689-3881
NPI assigned
Oct 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 019604 NY
Surgical Physician Assistant 363AS0400X 019604 NY Primary

Addresses

Primary practice location

121 Everett Rd
Albany, NY 12205-1474

Mailing address

121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663

Other practice location 1

3999 Via Lucero Apt A25
Santa Barbara, CA 93110-1682
Phone (518) 256-7164

Other identifiers 1

IdentifierTypeStateIssuer
04453696MedicaidNY

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
I20160511002478 NY Practitioner - Physician Assistant 8123270295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedicsny, LLPGroup PAC ID 6901898170, 115 clinicians

Practice addresses (Care Compare)

121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663

1768 Route 9
Halfmoon, NY 12065-2402
Phone (518) 489-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Promoting interoperability
75
Improvement activities
40
Cost
88.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22686CAMDChiropractor
019604NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedicsny, LLP CurrentSince May 1, 2016 Accepting new patients
Orthopedicsny, LLP CurrentSince May 1, 2016 Accepting new patients
Keith Mark Gross MD Inc Past Accepting new patients

Locations

3 Atrium Dr
Ste 150
Albany, NY 12205
Phone (518) 453-2361

123 Everett Rd
Ste 200
Albany, NY 12205

123 Everett Rd
Albany, NY 12205
Phone (518) 701-2000

121 Everett Rd
Colonie, NY 12205

1768 Route 9
Halfmoon, NY 12065

Interoperability endpoints

  • Direct secure messaging: gleder788844@direct.trinity-health.org
  • Direct secure messaging: gleder@orthony.emadirect.md

Organizations & group practices 3

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 3

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": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1033463930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051474",
            "telephone_number": "518-489-2663",
            "fax_number": "518-689-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 EVERETT RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051474",
            "telephone_number": "518-489-2663",
            "fax_number": "518-689-3881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3999 Via Lucero Apt A25",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931101682",
            "country_code": "US",
            "telephone_number": "518-256-7164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDER",
        "first_name": "GREGORY",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019604",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "019604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04453696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.