Individual provider Active NPI

Lauren Leeflang

  • Medical Physician Assistant
  • Fort Pierce, FL
National Provider Identifier
1306393145
Registry record updated Nov 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109766 Issued in FL
Practice address
356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone
(772) 464-9746
NPI assigned
Sep 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109766 FL Primary

Addresses

Primary practice location

356 E Midway Rd
Fort Pierce, FL 34982-7148

Mailing address

356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161114002242 FL Practitioner - Physician Assistant 6709165756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Infectious DiseasesGroup PAC ID 4486689957, 18 clinicians
Midway Specialty Care Center IncGroup PAC ID 9638306087, 30 clinicians

Practice addresses (Care Compare)

1801 SE Hillmoor Dr
Suite C 207
Port St Lucie, FL 34952-7574
Phone (772) 335-4234

356 E Midway Rd
Fort Pierce, FL 34982-7148
Phone (772) 464-9746

Hospital & facility affiliations

  • St Lucie Medical Center Hospital, Port Saint Lucie, FL, CCN 100260

National Provider Directory

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1306393145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 E MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827148",
            "telephone_number": "772-464-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 E MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349827148",
            "telephone_number": "772-464-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEFLANG",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.