Individual provider Active NPI

Abraham Eteuati Leiato, MBBS

  • Emergency Medicine Physician
  • Pago Pago, AS
National Provider Identifier
1144542234
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2047A Issued in AS
Practice address
1 Dr. Paul Turner Drive
Pago Pago, AS 96799
Phone
(684) 633-1222
Fax
(684) 633-1839
NPI assigned
Feb 17, 2010
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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 1090618 TX
Emergency Medicine Physician 207P00000X 2047A AS Primary

Addresses

Primary practice location

1 Dr. Paul Turner Drive
Pago Pago, AS 96799

Mailing address

1 Dr. Paul Turner Drive
Pago Pago, AS 96799
Phone (684) 633-1222

Other practice location 1

Carl R. Darnall Army Medical Center,
36000 Darnall Loop
Fort Hood, TX 76544
Phone (254) 466-9538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AS
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
I20241108003526 AS Practitioner - Emergency Medicine 5799219010 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2047AASMDEmergency Medicine Physician
1090618TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Samoa Medical Center CurrentSince Aug 25, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1144542234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DR. PAUL TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "96799",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DR. PAUL TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "96799",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Carl R. Darnall Army Medical Center,",
            "address_2": "36000 Darnall Loop",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "76544",
            "country_code": "US",
            "telephone_number": "254-466-9538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIATO",
        "first_name": "ABRAHAM",
        "middle_name": "ETEUATI",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1090618",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AS",
            "license": "2047A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pago Pago, AS

Sources for this page

Verify at the official NPI Registry.