Individual provider Active NPI

Jasmin Ann Lease, PA-C

  • Physician Assistant
  • Benton, AR
National Provider Identifier
1376792457
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-349 Issued in AR
Practice address
2010 Active Way
Benton, AR 72019-7566
Phone
(501) 315-0984
Fax
(501) 847-1405
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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 PA-349 AR Primary

Addresses

Primary practice location

2010 Active Way
Benton, AR 72019-7566

Mailing address

PO Box 3250
Benton, AR 72018-3250
Phone (501) 315-0984

Other identifiers 1

IdentifierTypeStateIssuer
PA349OtherARLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20140929000812 AR Practitioner - Physician Assistant 2466513601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saline Orthopedic Group P aGroup PAC ID 7911819479, 6 clinicians

Practice addresses (Care Compare)

2010 Active Way
Arkansas Bone and Joint
Benton, AR 72019-7566
Phone 5013150984306

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-349ARMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saline Orthopedic Group P a PastSince Jun 11, 2023 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1376792457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3250",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720183250",
            "telephone_number": "501-315-0984",
            "fax_number": "501-847-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ACTIVE WAY",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720197566",
            "telephone_number": "501-315-0984",
            "fax_number": "501-847-1405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEASE",
        "first_name": "JASMIN",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PA-349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA349",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.