Individual provider Active NPI

Devon E Leahy, PA-C

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1164836490
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA061194 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6130
Phone
(215) 662-3340
Fax
(215) 349-5890
NPI assigned
Jun 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Medical Physician Assistant 363AM0700X 25MP00568200 NJ
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X MA061194 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 662-3340

Other practice location 1

1865 Route 70 E Ste 220
Cherry Hill, NJ 08003-2005
Phone (856) 429-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200329000348 PA Practitioner - Physician Assistant 8729417662 Reassigns benefits to 2 organizations
I20201001000892 NJ Practitioner - Physician Assistant 8729417662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Jefferson Medical College of Thomas Jefferson University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

145 King of Prussia Rd
Radnor, PA 19087-4557

145 King of Prussia Rd 201
Radnor, PA 19087-4557

145 King of Prussia Rd 203
Radnor, PA 19087-4557

145 King of Prussia Rd 302
GYN/Onc Radnor
Radnor, PA 19087-4557
Phone (610) 902-2500

145 King of Prussia Rd N
G102 Oto Surgery Radnor
Philadelphia, PA 19087-4557
Phone (610) 902-5500

145 King of Prussia Rd N G
1 Rad Onc Rdanor
Radnor, PA 19087-4557
Phone (610) 902-4580

145 King of Prussia Road G-103
Oral/Maxillo Surg Radnor
Radnor, PA 19087-4557
Phone (610) 902-2100

230 W Washington Square
Philadelphia, PA 19106-3500

230 W Washington Square 2ND FLR
Thoracic Surg West Wash SQ
Philadelphia, PA 19106-3500
Phone (215) 829-2092

230 W Washington Square 5TH Floor
Orthopedic Foot and Ankle
Philadelphia, PA 19106-3500
Phone (215) 829-3668

3400 Spruce St
Philadelphia, PA 19104-4206

3400 Spruce Street 5 White BLDG
Oral and Maxillofacial Surgery Hup
Philadelphia, PA 19104-4206
Phone (215) 829-6079

3737 Market St
Philadelphia, PA 19104-5544

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00568200NJMDMedical Physician Assistant
MA061194PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, P.C. Multi-Specialty CurrentSince Sep 23, 2020 Accepting new patients
Clinical Health Care Associates of New Jersey, PC Multi-Specialty CurrentSince Sep 23, 2020 Accepting new patients
University of Penn-Medical Group Multi-Specialty CurrentSince Feb 3, 2020 Accepting new patients
University of Penn-Medical Group Multi-Specialty CurrentSince Feb 3, 2020 Accepting new patients
University of Penn - Medical Group Multi-Specialty CurrentSince Apr 1, 2020 Accepting new patients

Locations

1865 Route 70 E
Ste 220
Cherry Hill, NJ 08003
Phone (856) 429-0505

1006 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-6880

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

230 W Washington Sq
Fl 5
Philadelphia, PA 19106
Phone (215) 829-3668

PO B0x 824320
Philadelphia, PA 19182

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1402704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1164836490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-662-3340",
            "fax_number": "215-349-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-662-3340",
            "fax_number": "215-349-5890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1865 Route 70 E Ste 220",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032005",
            "country_code": "US",
            "telephone_number": "856-429-0505",
            "fax_number": "856-427-9468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "DEVON",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-14",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00568200",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA061194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.