Individual provider Active NPI

Elena Catherine Leschack

  • Physician Assistant
  • Fort Mill, SC
National Provider Identifier
1205699550
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5526 Issued in SC
Practice address
601 Sutton Rd S Ste 201
Fort Mill, SC 29715-8439
Phone
(803) 547-3800
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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
Physician Assistant 363A00000X 5526 SC Primary

Addresses

Primary practice location

601 Sutton Rd S Ste 201
Fort Mill, SC 29715-8439

Mailing address

601 Sutton Rd S
Fort Mill, SC 29715-8439
Phone (803) 547-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250108003560 SC Practitioner - Physician Assistant 4385172089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 S Herlong a
Rock Hill, SC 29732-1182
Phone (803) 328-1864

601 Sutton Rd S
Suite 201
Fort Mill, SC 29715-8439
Phone (803) 547-3800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, PA CurrentSince Nov 5, 2024 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Physician Assistant CurrentSince Nov 5, 2024 Accepting new patients

Locations

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

2325 W Arbors Dr
Ste 201
Charlotte, NC 28262
Phone (704) 295-3500

601 Sutton Rd S
Ste 201
Fort Mill, SC 29715
Phone (803) 328-1864

200 Herlong Ave S
Ste A
Rock Hill, SC 29732
Phone (803) 324-1028

Interoperability endpoints

  • Direct secure messaging: eleschack39000@direct.ceenta.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 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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1205699550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SUTTON RD S",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158439",
            "telephone_number": "803-547-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SUTTON RD S STE 201",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158439",
            "telephone_number": "803-547-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESCHACK",
        "first_name": "ELENA",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "5526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.