Individual provider Active NPI

Leslie Q. Horita, PA-C

  • Physician Assistant
  • Kirkland, WA
National Provider Identifier
1114748126
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
68349 Issued in CA
Practice address
12911 120TH Ave NE Ste H210
Kirkland, WA 98034-3065
Phone
(425) 823-4000
Fax
(425) 821-3550
NPI assigned
Oct 22, 2024
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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 68349 CA Primary
Surgical Physician Assistant 363AS0400X PA61627574 WA

Addresses

Primary practice location

12911 120TH Ave NE Ste H210
Kirkland, WA 98034-3065

Mailing address

12911 120TH Ave NE Ste G10
Kirkland, WA 98034-3048
Phone (425) 823-4000

Other practice location 1

4300 El Camino Real Ste 100
Los Altos, CA 94022-1090
Phone (650) 325-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20250227001332 WA Practitioner - Physician Assistant 6406376979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

12911 120TH Ave NE
Suite H210
Kirkland, WA 98034-3065
Phone (425) 823-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA61627574WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Surgical CurrentSince Feb 17, 2025 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Feb 17, 2025 Accepting new patients

Locations

12911 120th Ave NE
Ste G10
Kirkland, WA 98034
Phone (425) 481-6301

12911 120th Ave NE
Ste H210
Kirkland, WA 98034
Phone (425) 823-4000

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1114748126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE G10",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343048",
            "telephone_number": "425-823-4000",
            "fax_number": "425-821-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE H210",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343065",
            "telephone_number": "425-823-4000",
            "fax_number": "425-821-3550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 El Camino Real Ste 100",
            "address_purpose": "LOCATION",
            "city": "Los Altos",
            "state": "CA",
            "postal_code": "940221090",
            "country_code": "US",
            "telephone_number": "650-325-6000",
            "fax_number": "650-325-8091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORITA",
        "first_name": "LESLIE",
        "middle_name": "Q.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "68349",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61627574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.