Active NPI
Leah J Treadwell, MD
- Family Medicine Physician
- Kyle, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M4601
- Practice address
- 4100 Everett Dr Ste 400
Kyle, TX 78640-6147 - Phone
- (512) 295-1333
- Fax
- (512) 406-7327
- NPI assigned
- Aug 29, 2006
- Last updated
- May 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 04-46862 | KS | |
| Family Medicine Physician | 207Q00000X | C183324 | CA | |
| Family Medicine Physician | 207Q00000X | 72413 | MN | |
| Family Medicine Physician | 207Q00000X | C0964 | KY | |
| Family Medicine Physician | 207Q00000X | MED-PHYS-LIC-9545 | MT | |
| Family Medicine Physician | 207Q00000X | 54637 | CO | |
| Family Medicine Physician | 207Q00000X | D0095422 | MD | |
| Family Medicine Physician | 207Q00000X | MD213434 | OR | |
| Family Medicine Physician | 207Q00000X | 67980 | AZ | |
| Family Medicine Physician | 207Q00000X | M4601 | TX | Primary |
Addresses
Primary practice location
4100 Everett Dr Ste 400
Kyle, TX 78640-6147
Mailing address
6210 E Hwy 290
Austin, TX 78723-1142
Phone (512) 483-9596
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 188404103 | Medicaid | TX | |
| 188404104 | Medicaid | TX | |
| 188404101 | Medicaid | TX | |
| 188404102 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070130000205 | TX | Practitioner - Family Practice | 8224925946 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Iowa, RJ & L Carver College of Medicine, 1996
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
15 Grumman Rd W
Suite 1400
Bethpage, NY 11714-5029
4515 Seton Ctr Pkwy
Suite 215 Credentialing
Austin, TX 78759-0726
6210 E Hwy 290
Suite 420
Austin, TX 78723-1142
6210 E US Hwy 290
Suite 420
Austin, TX 78723-1098
P O Box
Suite 3409
Pflugerville, TX 78691-3409
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67980 | AZ | MD | Family Medicine Physician |
| C183324 | CA | MD | Family Medicine Physician |
| 54637 | CO | MD | Family Medicine Physician |
| 04-46862 | KS | MD | Family Medicine Physician |
| C0964 | KY | MD | Family Medicine Physician |
| D0095422 | MD | MD | Family Medicine Physician |
| 72413 | MN | MD | Family Medicine Physician |
| MED-PHYS-LIC-9545 | MT | MD | Family Medicine Physician |
| MD213434 | OR | MD | Family Medicine Physician |
| M4601 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Provider Health PA | Past | Accepting new patients | |
| Logan Health - Whitefish | Past | Accepting new patients | |
| Family Health Care PC | Past | Accepting new patients |
Organizations & group practices 3
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.
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dba Logan Health Rural Health Clinic- Eureka
- Rural Health Clinic/Center
- Eureka, MT
- NPI 1336115849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716508800000",
"number": "1437267291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6210 E HWY 290",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787231142",
"telephone_number": "512-483-9596",
"fax_number": "512-406-6216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 EVERETT DR STE 400",
"city": "KYLE",
"state": "TX",
"postal_code": "786406147",
"telephone_number": "512-295-1333",
"fax_number": "512-406-7327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREADWELL",
"first_name": "LEAH",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2024-05-24",
"certification_date": "2024-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "04-46862",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C183324",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "72413",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "C0964",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MT",
"license": "MED-PHYS-LIC-9545",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "54637",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0095422",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD213434",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "67980",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "M4601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "188404103",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "188404104",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "188404101",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "188404102",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kyle, TX
- Scott William Tolan, M.D.
- Micah D Tomlinson, M.D.
- Total Child Therapy Center
- Total Child Therapy Home Health PLLC (Total Child Therapy Home Health)
- Candiss Ryan Trager, FNP-C
- Tri-County Practice Association (Seton Spine and Scoliosis Center)
- Rita Tripathy, MD
- Natasha Elizabeth Triplett
- Krysten D Tucker, LMT
- Christie Turner, PMHNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.