Individual provider Active NPI

Christi Leigh Saklad-Costello, PA

  • Physician Assistant
  • Palm Coast, FL
National Provider Identifier
1316933880
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109647 Issued in FL
Practice address
8 Office Park Dr
Palm Coast, FL 32137-3808
Phone
(866) 400-3376
Fax
(863) 446-6066
NPI assigned
Sep 21, 2005
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MA051738 PA
Medical Physician Assistant 363AM0700X MA051738 PA
Physician Assistant 363A00000X PA9109647 FL Primary

Addresses

Primary practice location

8 Office Park Dr
Palm Coast, FL 32137-3808

Mailing address

151 Southhall LN Ste 300
Maitland, FL 32751-7172
Phone (866) 400-3376

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
I20161104000561 FL Practitioner - Physician Assistant 6709912454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100

1503 Buenos Aires Blvd
Suite 100
The Villages, FL 32159-6825
Phone (352) 753-2812

71 Doctors Village Dr
Suite 304
Saint Johns, FL 32259-2406
Phone (904) 547-2580

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109647FLMDPhysician Assistant
MA051738PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Aug 16, 2016 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Aug 16, 2016 Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients
Leavitt Medical Associates of Florida Inc Past Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

8 Office Park Dr
Palm Coast, FL 32137
Phone (386) 446-4466

71 Doctors Village Dr
Ste 304
Saint Johns, FL 32259
Phone (904) 547-2580

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1316933880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "866-400-3376",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 OFFICE PARK DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373808",
            "telephone_number": "866-400-3376",
            "fax_number": "863-446-6066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKLAD-COSTELLO",
        "first_name": "CHRISTI",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MA051738",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051738",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.