Leanne R. Cota, PA-C
Individual provider Active NPI Physician Assistant · Tanana, AK
NPI 1174630180 · NPPES record last updated Jun 17, 2021
Key facts
- NPI
- 1174630180
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 170876 (AK)
- Practice address
- 150 Front St
Tanana, AK 99777 - Phone
- (907) 366-7222
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MT, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150311001681 | MT | Practitioner - Physician Assistant | 1850309865 | Reassigns benefits to 1 organization |
| I20210604000079 | TX | Practitioner - Physician Assistant | 1850309865 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 170876 | AK | MD | Physician Assistant |
| 36234 | MT | MD | Physician Assistant |
| PA0000001325 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Country Home Medicine | Current |
Accepting new patients | |
| Glendive Medical Center, Inc | Current | Accepting new patients | |
| Glendive Medical Center, Inc | Current |
Accepting new patients | |
| Tanana Chiefs Conference | Current |
Accepting new patients | |
| Chattanooga Spine & Rehabilitation PLLC | Past | Accepting new patients | |
| Chattanooga Rehabilitation Associates, PC | Past | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Locations
202 Prospect Dr
Glendive, MT 59330
Phone (406) 345-3306
Interoperability endpoints
- lbreihahn@gmc.cernerdirect.com
- https://api.platform.athenahealth.com/19677/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 36234 | MT | |
| Physician Assistant | 363A00000X | PA0000001325 | TN | |
| Physician Assistant | 363A00000X | 170876 | AK | Yes |
Addresses
Primary practice location
150 Front St
Tanana, AK 99777
Mailing address
PO Box 4
Plevna, MT 59344-0004
Phone (406) 778-7750
Other practice location 1
202 S 4th St W
Baker, MT 59313-9156
Phone (406) 778-3331
Other practice location 2
104 4th St South
Plevna, MT 59344
Phone (406) 778-7750
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 170876 | Other | AK | ALASKA MEDICAL LICENSE |
| MEDPACLIC36234 | Other | MT | MONTANA MEDICAL LICENSE |
| PA0000001325 | Other | TN | MEDICAL LICENSE NUMBER |
Other names
- Leanne R. Breihahn
Other providers in Tanana, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.