Lizette Leach, PA-C

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

1852 N Mastick Way
Nogales, AZ 85621-1063

Phone

(520) 281-1550

Fax

(520) 281-1112

NPI assigned

Sep 24, 2018

Last updated

Mar 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mariposa Community Health Center IncGroup PAC ID 8123926326, shared by 8 NPIs, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lizette.leachpa.p1@direct.azch.nextgenshare.com

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.

• Judah D Pifer MD, PLLC

  • Orthopaedic Surgery Physician
  • Prescott, AZ
  • NPI 1861735490
  Medicare reassignment
• Mariposa Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Rio Rico, AZ
  • NPI 1013213404

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1376027540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N GRAND AVE STE 100",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211061",
            "telephone_number": "520-281-1550",
            "fax_number": "520-281-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1852 N MASTICK WAY",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856211063",
            "telephone_number": "520-281-1550",
            "fax_number": "520-281-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3655 Crossings Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863057101",
            "country_code": "US",
            "telephone_number": "928-778-9250",
            "fax_number": "928-778-2306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "LIZETTE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7306",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "482965",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS",
            "identifier": "7306",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simran Shashi Kapur, M.D.
• Carolyn Frances Kenngott, CRNA
• Sunghyun Kim, PHARMACIST
• James Lindsey King, CRNA
• Alexander Nam Le, PHARMD
• Alicia Serna Leon
• Leysan, LLC (Cimarron Assisted Living)
• Brenda Berenice Lizarraga, RN
• Greta Liz Lopez, DNP, AGPCNP-BC,PMHNP
• James A Lopez, DMD

• Community/Behavioral Health Agency in Nogales, AZ
• Providers in Nogales, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.