Individual provider Active NPI

Leta A Hice, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1205006186
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40380 Issued in AZ
Practice address
2020 N Central Ave
Suite 1010
Phoenix, AZ 85004-4501
Phone
(602) 553-8400
Fax
(602) 553-8408
NPI assigned
Mar 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ
Internal Medicine Physician 207R00000X 40380 AZ Primary

Addresses

Primary practice location

2020 N Central Ave
Suite 1010
Phoenix, AZ 85004-4501

Mailing address

2020 N Central Ave
Suite 1010
Phoenix, AZ 85004-4501
Phone (602) 553-8400

Other practice location 1

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Other identifiers 1

IdentifierTypeStateIssuer
336597MedicaidAZ

Other names 1

  • Dr. Leta A House Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20080616000768 AZ Practitioner - HospitalistPractitioner - Internal Medicine 8123199353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Temple University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
78.73
Promoting interoperability
98
Improvement activities
40
Cost
62.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40380AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Arizona PC Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Oct 1, 2021 Accepting new patients
Banner - University Hospital Based Physicians LLC CurrentSince Oct 1, 2021 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

16640 N 38th St
Phoenix, AZ 85032
Phone (602) 482-6671

2020 N Central Ave
Ste 1010
Phoenix, AZ 85004
Phone (602) 553-8400

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

350 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 873-3000

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 4

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 1

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": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1205006186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N CENTRAL AVE",
            "address_2": "SUITE 1010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044501",
            "telephone_number": "602-553-8400",
            "fax_number": "602-553-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N CENTRAL AVE",
            "address_2": "SUITE 1010",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044501",
            "telephone_number": "602-553-8400",
            "fax_number": "602-553-8408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 E McDowell Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062612",
            "country_code": "US",
            "telephone_number": "602-839-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICE",
        "first_name": "LETA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "40380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336597",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LETA",
            "last_name": "HOUSE",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.