Individual provider Active NPI

Leah Katherine Gorsline, RPA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1114104668
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012177-1 Issued in NY
Practice address
1500 Broadway St
Buffalo, NY 14212-1845
Phone
(716) 891-2015
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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 012177-1 NY Primary

Addresses

Primary practice location

1500 Broadway St
Buffalo, NY 14212-1845

Mailing address

1500 Broadway Ave
Buffalo, NY 14212

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
I20080327000555 NY Practitioner - Physician Assistant 4385720515 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012177NYMDMassage Therapist
012177-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
County of Erie Comptrollers Office Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1114104668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BROADWAY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BROADWAY ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142121845",
            "telephone_number": "716-891-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORSLINE",
        "first_name": "LEAH",
        "middle_name": "KATHERINE",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012177-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.