Individual provider Active NPI

Joseph James Leveille

  • Physician Assistant
  • Blaine, MN
National Provider Identifier
1366814139
Registry record updated Oct 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11959 Issued in MN
Practice address
1500 109TH Ave NE
Blaine, MN 55449-4670
Phone
(218) 310-9719
NPI assigned
Oct 20, 2015
Last updated
Oct 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11959 MN Primary

Addresses

Primary practice location

1500 109TH Ave NE
Blaine, MN 55449-4670

Mailing address

519 W 22ND St
Minneapolis, MN 55405
Phone (218) 310-9719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20151207000392 MN Practitioner - Physician Assistant 5698075174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
83.31
Improvement activities
40
Cost
83.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2368MNMDOptometrist
11959MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Primary Care Minnesota PLLC Physician Assistant CurrentSince Oct 8, 2025 Accepting new patients

Locations

4241 Johnny Cake Ridge Rd
Eagan, MN 55122
Phone (651) 688-7041

1010 W Lake St
Minneapolis, MN 55408
Phone (612) 822-1297

1500 109th Ave NE
Minneapolis, MN 55449
Phone (763) 354-1000

1040 Grand Ave
Saint Paul, MN 55105
Phone (651) 224-2155

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1366814139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 W 22ND ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55405",
            "telephone_number": "218-310-9719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 109TH AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494670",
            "telephone_number": "218-310-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVEILLE",
        "first_name": "JOSEPH",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.