Individual provider Active NPI

Emily Leech, PA-C

  • Medical Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1346716743
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9111751 Issued in FL
Practice address
640 21St St
Vero Beach, FL 32960-0933
Phone
(772) 299-1092
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9111751 FL Primary
Physician Assistant 363A00000X PAX000015159 FL

Addresses

Primary practice location

640 21St St
Vero Beach, FL 32960-0933

Mailing address

2562 Cheval St Apt 107
Orlando, FL 32828-7634
Phone (814) 795-9854

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAX000015159FLMDPhysician Assistant
PA9111751FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc Past Accepting new patients
Farmington Hills Urgent Care Walk-in Clinic PC PastSince Jul 31, 2022 Accepting new patients
First Choice Medical Group PLLC Past Accepting new patients

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1346716743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562 CHEVAL ST APT 107",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287634",
            "telephone_number": "814-795-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 21ST ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600933",
            "telephone_number": "772-299-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEECH",
        "first_name": "EMILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9111751",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAX000015159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.