Active NPI
Leslie D Jansa, PA
- Physician Assistant
- San Angelo, TX
National Provider Identifier
1326324757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 4450 Sunset Dr
San Angelo, TX 76901-5611 - Phone
- (325) 658-1511
- Fax
- (325) 481-2165
- NPI assigned
- Oct 31, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | TX | ||
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
4450 Sunset Dr
San Angelo, TX 76901-5611
Mailing address
PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 863N49 | Other | TX | BCBS |
| 312780501 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375920000000",
"number": "1326324757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22000",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769027200",
"telephone_number": "325-658-1511",
"fax_number": "325-481-2165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4450 SUNSET DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769015611",
"telephone_number": "325-658-1511",
"fax_number": "325-481-2165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSA",
"first_name": "LESLIE",
"middle_name": "D",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2013-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "863N49",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "312780501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.