NPIMap

Individual provider Active NPI

Leisa A Boykin Willson, PA

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1295879062
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1539 Issued in CO
Practice address
311 Steele St
Denver, CO 80206-4479
Phone
(303) 372-4000
Fax
(303) 372-4001
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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 1539 CO Primary

Addresses

Primary practice location

311 Steele St
Denver, CO 80206-4479

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4451

Other practice location 1

8155 Piney River Ave Ste 100
Littleton, CO 80125-8729
Phone (303) 265-3370

Other practice location 2

16951 E Quincy Ave
Aurora, CO 80015-1901
Phone (303) 752-5480

Other identifiers 2

IdentifierTypeStateIssuer
16377044MedicaidCO
004704OtherKAISER-COMMERCIAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000841 CO Practitioner - Physician Assistant 5991756223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

311 Steele St
Denver, CO 80206-4414
Phone (303) 372-4010

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Apr 11, 2022 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Apr 11, 2022 Accepting new patients
Uchealth Community Services Past Accepting new patients

Locations

15240 W 64th Ave
Arvada, CO 80007
Phone (303) 463-7180

16951 E Quincy Ave
Aurora, CO 80015
Phone (303) 752-5470

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

4404 Barranca Ln
Ste 101
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

5589 Argonne St
Denver, CO 80249
Phone (303) 371-0330

311 Steele St
Denver, CO 80206
Phone (303) 372-4000

4660 Yosemite St
Ste 100
Denver, CO 80238
Phone (720) 516-8900

9475 S University Blvd
Highlands Ranch, CO 80126
Phone (303) 470-4061

8155 Piney River Ave
Ste 100
Littleton, CO 80125
Phone (303) 265-3370

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

13631 Colorado Blvd
Thornton, CO 80602
Phone (303) 252-2960

Organizations & group practices 3

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 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1295879062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4451",
            "fax_number": "970-490-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 STEELE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802064479",
            "telephone_number": "303-372-4000",
            "fax_number": "303-372-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8155 Piney River Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801258729",
            "country_code": "US",
            "telephone_number": "303-265-3370",
            "fax_number": "303-265-3371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16951 E Quincy Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800151901",
            "country_code": "US",
            "telephone_number": "303-752-5480",
            "fax_number": "303-753-5481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYKIN WILLSON",
        "first_name": "LEISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "1539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16377044",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER-COMMERCIAL NUMBER",
            "identifier": "004704",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.