Individual provider Active NPI

Christopher Michael Leberth II, PA

  • Medical Physician Assistant
  • Canandaigua, NY
National Provider Identifier
1356641583
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
229 Parrish St
Suite 100
Canandaigua, NY 14424-1791
Phone
(585) 394-1960
Fax
(585) 393-9232
NPI assigned
Oct 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

229 Parrish St
Suite 100
Canandaigua, NY 14424-1791

Mailing address

229 Parrish St
Suite 100
Canandaigua, NY 14424-1791
Phone (585) 394-1960

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": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1356641583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 PARRISH ST",
            "address_2": "SUITE 100",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241791",
            "telephone_number": "585-394-1960",
            "fax_number": "585-393-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 PARRISH ST",
            "address_2": "SUITE 100",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241791",
            "telephone_number": "585-394-1960",
            "fax_number": "585-393-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBERTH",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.