Individual provider Active NPI

Leah Ruth Streitman, PA-C

  • Physician Assistant
  • Eagan, MN
National Provider Identifier
1447649637
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11803 Issued in MN
Practice address
3460 Washington Dr Ste 200
Eagan, MN 55122
Phone
(651) 769-6200
Fax
(651) 769-6249
NPI assigned
Jan 12, 2015
Last updated
May 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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 11803 MN Primary

Addresses

Primary practice location

3460 Washington Dr Ste 200
Eagan, MN 55122

Mailing address

2497 7TH Ave E Ste 101
North Saint Paul, MN 55109-2946
Phone (651) 769-6437

Other practice location 1

1 Cvs Dr
Woonsocket, RI 02895-6146
Phone (866) 389-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150421002513 MN Practitioner - Physician Assistant 0143548206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bhsi LLCGroup PAC ID 3274504816, 33 clinicians

Practice addresses (Care Compare)

2497 7TH Ave E
Suite 101
North St Paul, MN 55109-2946
Phone (651) 769-6400

327 S Marschall Rd
Suite 250
Shakopee, MN 55379-2666
Phone (651) 769-6500

8441 Wayzata Blvd
Suite 140
Golden Valley, MN 55426-1366
Phone (651) 769-6300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11803MNMDPhysician 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": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1447649637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2497 7TH AVE E STE 101",
            "city": "NORTH SAINT PAUL",
            "state": "MN",
            "postal_code": "551092946",
            "telephone_number": "651-769-6437",
            "fax_number": "651-769-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 WASHINGTON DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "651-769-6200",
            "fax_number": "651-769-6249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Cvs Dr",
            "address_purpose": "LOCATION",
            "city": "Woonsocket",
            "state": "RI",
            "postal_code": "028956146",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STREITMAN",
        "first_name": "LEAH",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.