Individual provider Active NPI

Leslie A Price, PA-C

  • Physician Assistant
  • Portage, MI
National Provider Identifier
1265441703
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007305 Issued in MI
Practice address
7775 Angling Rd
Portage, MI 49024-7427
Phone
(269) 321-7120
Fax
(269) 321-7154
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.002183 OH
Physician Assistant 363A00000X 5601007305 MI Primary

Addresses

Primary practice location

7775 Angling Rd
Portage, MI 49024-7427

Mailing address

5943 Stadium Dr
Ste 1
Kalamazoo, MI 49009-3016
Phone (269) 552-2836

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150706001606 MI Practitioner - Physician Assistant 0244542272 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

7775 Angling Rd
Portage, MI 49024-7427
Phone (269) 321-7120

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007305MIMDPhysician Assistant
50.002183OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Jul 19, 2015 Accepting new patients
Ascension Borgess Hospital CurrentSince Apr 1, 2017 Accepting new patients
Ascension Medical Group Promed CurrentSince Jul 19, 2015 Accepting new patients
Ascension Medical Group Promed Past Accepting new patients

Locations

1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165

7775 Angling Rd
Portage, MI 49024
Phone (269) 321-7120

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 5

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1265441703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5943 STADIUM DR",
            "address_2": "STE 1",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093016",
            "telephone_number": "269-552-2836",
            "fax_number": "269-552-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7775 ANGLING RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490247427",
            "telephone_number": "269-321-7120",
            "fax_number": "269-321-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002183",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.