Jessica Suzahne Leist, PA-C
Individual provider Active NPI Physician Assistant · Lubbock, TX
NPI 1174778286 · NPPES record last updated Dec 6, 2021
Key facts
- NPI
- 1174778286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA06925 (TX)
- Practice address
- 3601 4TH St
Lubbock, TX 79430-3396 - Phone
- (806) 743-2373
- NPI assigned
- Nov 18, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.52 of 100
- Quality
- 87.98
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in 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 |
|---|---|---|---|---|
| I20110613000746 | TX | Practitioner - Physician Assistant | 5597828178 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.003344 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center Lubbock | Current |
Accepting new patients | |
| Regence Health Network Inc | Current |
Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Current |
Accepting new patients |
Locations
3113 Ross St
Amarillo, TX 79103
Phone (806) 374-7341
3601 4th St
Stop 8312
Lubbock, TX 79430
Phone (806) 743-2332
3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000
410 Canyon St
Plainview, TX 79072
Phone (806) 291-0297
Interoperability endpoints
- jessica.leist@direct.myteamcare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.003344 | IL | |
| Physician Assistant | 363A00000X | PA06925 | TX | Yes |
Addresses
Primary practice location
3601 4TH St
Lubbock, TX 79430-3396
Mailing address
3601 4TH St # Ms 8312
Lubbock, TX 79430-0002
Phone (806) 743-1501
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.