Individual provider Active NPI

Jennifer L Leathe, MD

  • Pediatrics Physician
  • Beverly, MA
National Provider Identifier
1093773608
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
154089 Issued in MA
Practice address
30 Tozer Rd Ste 101
Beverly, MA 01915-5514
Phone
(978) 745-3050
Fax
(978) 745-7014
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 154089 MA Primary

Addresses

Primary practice location

30 Tozer Rd Ste 101
Beverly, MA 01915-5514

Mailing address

900 Cummings Center
Suite 113T
Beverly, MA 01915
Phone (978) 777-3877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20250225000383 MA Practitioner - Pediatric Medicine 9830558857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York Medical College, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Pediatric Associates of Greater Salem IncGroup PAC ID 4284648270, 11 clinicians

Practice addresses (Care Compare)

30 Tozer Rd
Beverly, MA 01915-5502
Phone (978) 745-3050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
154089MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates of Greater Salem, Inc Pediatrics CurrentSince Dec 16, 2024 Accepting new patients
Kids Health LLC Pediatrics Past Accepting new patients

Locations

30 Tozer Rd
Beverly, MA 01915
Phone (978) 712-1100

30 Tozer Rd
Ste 101
Beverly, MA 01915
Phone (978) 745-3050

30 Tozer Rd
Fl 1
Beverly, MA 01915

84 Highland Ave
Ste 101
Salem, MA 01970
Phone (978) 745-3050

Interoperability endpoints

  • Direct secure messaging: jennifer.leathe.1@2804.direct.athenahealth.com
  • Direct secure messaging: leathe.jennifer.pags@direct.partners.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/2804/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1093773608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CENTER",
            "address_2": "SUITE 113T",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-777-3877",
            "fax_number": "978-774-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 TOZER RD STE 101",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155514",
            "telephone_number": "978-745-3050",
            "fax_number": "978-745-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHE",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "154089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.