Jeffrey Park Leake, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD00023374 Issued in WA

Practice address

851 S Rampart Blvd
Sutie 220
Las Vegas, NV 89145-4882

Phone

(702) 947-7907

Fax

(702) 947-7907

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 20, 2016 through Sep 20, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Independent Anesthesiologists of Kitsap Co

  • Anesthesiology Physician
  • Bremerton, WA
  • NPI 1285795815
  NPD (past) Authorized official
• Olympic Anesthesia Services, Inc

  • Anesthesiology Physician
  • Bremerton, WA
  • NPI 1275586125
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1427119049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 S RAMPART BLVD",
            "address_2": "SUTIE 220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454882",
            "telephone_number": "702-947-7907",
            "fax_number": "702-947-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S RAMPART BLVD",
            "address_2": "SUTIE 220",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891454882",
            "telephone_number": "702-947-7907",
            "fax_number": "702-947-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAKE",
        "first_name": "JEFFREY",
        "middle_name": "PARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00023374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011311",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Leach
• Stone Tyler Leachman, DO
• Tanisha Leadbetter
• Mariah League
• Kayla Leahy, OTA
• Jennifer Ann Leake, MSN, APRN, FNP-BC
• Maria Kristina Leake, DMD
• Ryan Gabriel Leake, MA
• William McKinley Leakes
• Walter Leaks

• Anesthesiology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Anesthesiology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.