Individual provider Active NPI

Brittany Lebeiko, PA-C

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1194459420
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
63646 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3391
Phone
(559) 256-5200
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 63646 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3391

Mailing address

5850 E Still Cir
Mesa, AZ 85206-3618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240110001946 CA Practitioner - Physician Assistant 7113378597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians

Practice addresses (Care Compare)

1630 E Herndon Ave
Fresno, CA 93720-3391
Phone (559) 290-7051

2151 Herndon Ave
Suite 105
Clovis, CA 93611-6307
Phone (559) 256-5200

2335 E Kashian LN
Fresno, CA 93701-2234

Hospital & facility affiliations

  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Community Foundation Medical Group Past Accepting new patients

Locations

1630 E Herndon Ave
Fresno, CA 93720
Phone (559) 256-5200

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

Interoperability endpoints

  • Direct secure messaging: brittany.lebeiko.p1@direct.spocortho.nextgenshare.com

Organizations & group practices 2

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 2

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1194459420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203391",
            "telephone_number": "559-256-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBEIKO",
        "first_name": "BRITTANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.