Active NPI
Maysie Jones Van Leeuwen
- Physician Assistant
- Sandy, UT
National Provider Identifier
1376204222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 870 E 9400 S Ste 109
Sandy, UT 84094-3687 - Phone
- (385) 271-9720
- Fax
- (800) 455-1391
- NPI assigned
- Jan 4, 2022
- Last updated
- Jan 2, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | Primary |
Addresses
Primary practice location
870 E 9400 S Ste 109
Sandy, UT 84094-3687
Mailing address
870 E 9400 S Ste 109
Sandy, UT 84094-3687
Phone (385) 271-9720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Nevada School of Medicine, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1180 Selmi Dr
Suite 201
Reno, NV 89512-4776
Phone (775) 433-2222
870 E 9400
Suite 109
Sandy, UT 84094-3687
Phone (385) 271-9720
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735776000000",
"number": "1376204222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 E 9400 S STE 109",
"city": "SANDY",
"state": "UT",
"postal_code": "840943687",
"telephone_number": "385-271-9720",
"fax_number": "800-455-1391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 E 9400 S STE 109",
"city": "SANDY",
"state": "UT",
"postal_code": "840943687",
"telephone_number": "385-271-9720",
"fax_number": "800-455-1391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN LEEUWEN",
"first_name": "MAYSIE",
"middle_name": "JONES",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-04",
"last_updated": "2025-01-02",
"certification_date": "2025-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.