Individual provider Active NPI

Leslie Brett Flake

  • Physician Assistant
  • Holbrook, AZ
National Provider Identifier
1356960223
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8203 Issued in AZ
Practice address
2109 Navajo Blvd
Holbrook, AZ 86025-1822
Phone
(928) 524-2851
Fax
(928) 524-2171
NPI assigned
Apr 10, 2020
Last updated
Apr 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8203 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2109 Navajo Blvd
Holbrook, AZ 86025-1822

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Other names 1

  • Leslie Brett Brewer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20201124000822 AZ Practitioner - Physician Assistant 8325459340 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

435 N 5TH St
Phoenix, AZ 85004-2157

450 W Paseo Redondo
Tucson, AZ 85701-8274

PO Box
Suite 3630
Flagstaff, AZ 86003

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8203AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. CurrentSince Dec 1, 2020 Accepting new patients
North Country Healthcare, Inc. Family Medicine Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Dec 1, 2020 Accepting new patients
North Country Healthcare, Inc. Past Accepting new patients

Locations

1501 S Yale St
Ste 252
Flagstaff, AZ 86001
Phone (928) 774-1811

2109 Navajo Blvd
Holbrook, AZ 86025
Phone (928) 213-6100

2650 E Show Low Lake Rd
Ste 1
Show Low, AZ 85901
Phone (928) 537-4300

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1356960223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 NAVAJO BLVD",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860251822",
            "telephone_number": "928-524-2851",
            "fax_number": "928-524-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAKE",
        "first_name": "LESLIE",
        "middle_name": "BRETT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8203",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "BREWER",
            "middle_name": "BRETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holbrook, AZ

Sources for this page

Verify at the official NPI Registry.