Prescott Michelle Lederer, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56373 Issued in CA

Practice address

720 E San Ysidro Blvd
San Ysidro, CA 92173-3101

Phone

(619) 662-2286

NPI assigned

Feb 19, 2019

Last updated

Feb 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Loma Linda University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wound Care 360 Advanced Solutions IncGroup PAC ID 2769912906, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wound Care 360 Advanced Solutions Inc

  • General Practice Physician
  • Encinitas, CA
  • NPI 1942012539
  Medicare reassignment Care Compare group NPD
• Sinu-Clear Inc

  • Otolaryngology Physician
  • Encino, CA
  • NPI 1831298751
  Medicare reassignment NPD

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1417413048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5691 LINDA ROSA AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920377539",
            "telephone_number": "619-371-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E SAN YSIDRO BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921733101",
            "telephone_number": "619-662-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERER",
        "first_name": "PRESCOTT",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jr's Trauma Care Initiative
• Kent Edward Karras, DC
• Mike Najah Katy
• Mely Knott
• Michele A. Lamantia, MD
• Leo Salutem Inc (Lyons Pharmacy)
• Leo Salutem Inc (Lyons Pharmacy)
• Monica Leon-Lopez, HEALTH SCIENCE, B.S.
• David Lepez, MD
• Jenifer Leuck, PHARM D

• Physician Assistant in San Ysidro, CA
• Providers in San Ysidro, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.