Stephanie Lynn Leach, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006171 Issued in MI

Practice address

426 Michigan St NE
Grand Rapids, MI 49503-5609

Phone

(616) 267-8338

NPI assigned

Sep 20, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Lynn Krause Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Ecs Western Michigan PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1992281000
  Medicare reassignment
• Visionary Medical Services PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1538216569
  Medicare reassignment
• Spectrum Health Primary Care Partners

  • Radiology Clinic/Center
  • Grand Rapids, MI
  • NPI 1528374683
  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Metropolitan Enterprises Inc.

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1770550105

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1316229040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035609",
            "telephone_number": "616-267-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KRAUSE",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marzia Leacche, M.D.
• Aaron Joseph Leach, MD
• Ashley Lynn Leach, PA-C
• Erin Gabrielle Leach, MD
• Megan Anne Leach
• Christine Leadbetter, LPCC
• Alex Leahy
• Constance Leahy, MD
• Seth Andrew Leali
• Leanne Jansen Counseling, PLLC

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.