Individual provider Active NPI

Jermaine Leclerc

  • Anesthesiologist Assistant
  • Greenville, SC
National Provider Identifier
1346492428
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
96 Issued in SC
Practice address
7 Independence PT Ste 300
Greenville, SC 29615-4569
Phone
(864) 522-3700
Fax
(864) 522-3705
NPI assigned
Oct 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X AA000016 DC
Anesthesiologist Assistant 367H00000X AA121 FL
Anesthesiologist Assistant 367H00000X 96 SC Primary

Addresses

Primary practice location

7 Independence PT Ste 300
Greenville, SC 29615-4569

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842

Other practice location 1

110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120907000661 FL Practitioner - Anesthesiology Assistant 2062578263 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Anesthesia and Pain Treatment PAGroup PAC ID 8426201401, 88 clinicians

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

Hospital & facility affiliations

  • St Mary'S Medical Center Hospital, West Palm Beach, FL, CCN 100288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA000016DCMDSpecialist
96SCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
PBG Team Anesthesia PA CurrentSince Jun 1, 2024 Accepting new patients
Cleveland Clinic Florida a Nonprofit Corporation CurrentSince Apr 27, 2020 Accepting new patients
Jupiter Anesthesia Associates LLC CurrentSince May 1, 2024 Accepting new patients
Anesthesia Medicine Services of FL, LLC CurrentSince May 30, 2023 Accepting new patients
Jupiter Anesthesia Associates LLC CurrentSince May 1, 2024 Accepting new patients
South Florida Anesthesia & Pain Treatment, P.a. CurrentSince Nov 1, 2024 Accepting new patients
Washington Hospital Center Corp Past Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

6700 Lake Nona Blvd
Orlando, FL 32827
Phone (689) 216-8000

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

2950 Cleveland Clinic Blvd
Weston, FL 33331
Phone (954) 689-5000

Organizations & group practices 7

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": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1346492428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 INDEPENDENCE PT STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154569",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LECLERC",
        "first_name": "JERMAINE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "DC",
            "license": "AA000016",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA121",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "SC",
            "license": "96",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.