NPIMap

Individual provider Active NPI

Leanne M Camisa, M.D.

  • Family Medicine Physician
  • Placerville, CA
National Provider Identifier
1124081377
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A060768 Issued in CA
Practice address
1095 Marshall Way
Placerville, CA 95667-5722
Phone
(530) 626-2920
NPI assigned
Apr 10, 2006
Last updated
Feb 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A060768 CA Primary

Addresses

Primary practice location

1095 Marshall Way
Placerville, CA 95667-5722

Mailing address

PO Box 45680
San Francisco, CA 94145-6504
Phone (530) 626-2618

Other identifiers 1

IdentifierTypeStateIssuer
00A607680MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070402000655 CA Practitioner - Family Practice 0941304042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

1095 Marshall Way
Suite 100
Placerville, CA 95667-5722
Phone (530) 626-2920

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A060768CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Marshall Medical Center Past Accepting new patients
Marshall Medical Center Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

3501 Palmer Dr
Ste 201
Cameron Park, CA 95682
Phone (530) 626-2611

4201 Town Center Blvd
Bldg D
El Dorado Hills, CA 95762
Phone (530) 344-5400

5137 Golden Foothill Pkwy
Ste 120
El Dorado Hls, CA 95762
Phone (530) 344-5400

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

1095 Marshall Way
Placerville, CA 95667
Phone (530) 626-2920

1095 Marshall Way
Ste 100
Placerville, CA 95667
Phone (530) 344-5470

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marshall HospitalPlacerville, CA, CCN 050254 Hospital Corporate Director (6.66%) Jan 1, 2025
Divide Wellness CenterGeorgetown, CA, CCN 058514 Rural health clinic Corporate Director Jan 1, 2025
Marshall Medical CenterPlacerville, CA, CCN 058682 Rural health clinic Corporate Director Jan 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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 7

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1124081377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45680",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941456504",
            "telephone_number": "530-626-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MARSHALL WAY",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675722",
            "telephone_number": "530-626-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMISA",
        "first_name": "LEANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A060768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A607680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.