Lauren Leavitt, PA
Individual provider Active NPI Physician Assistant · Heathrow, FL
NPI 1457789307 · NPPES record last updated Oct 30, 2013
Key facts
- NPI
- 1457789307
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA-9107547 (FL)
- Practice address
- 120 International Parkway
Suite 300
Heathrow, FL 32746 - Phone
- (407) 333-4200
- Fax
- (407) 829-6637
- NPI assigned
- Oct 30, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Leavitt Medical Associates of Florida Inc
Practice addresses (Care Compare)
120 International Pkwy
Suite 240
Heathrow, FL 32746-5033
Phone (407) 333-4200
1410 W Broadway St
Suite 205
Oviedo, FL 32765-6472
Phone (407) 359-2100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140219001692 | FL | Practitioner - Physician Assistant | 3971733866 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-9107547 | FL | MD | Physician Assistant |
Practice roles (3 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Leavitt Medical Associates of Florida Inc | Current |
Accepting new patients | |
| Leavitt Medical Associates of Florida Inc | Current |
Accepting new patients | |
| Leavitt Medical Associates of Florida Inc | Past | Accepting new patients |
Locations
120 International Pkwy
Ste 240
Lake Mary, FL 32746
Phone (407) 333-4200
151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293
1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100
1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-9107547 | FL | Yes |
Addresses
Primary practice location
120 International Parkway
Suite 300
Heathrow, FL 32746
Mailing address
151 Southhall Lane
Suite 300
Maitland, FL 32751
Phone (407) 875-2080
Other providers in Heathrow, FL
- Grete Kofoed
- Natalie Kwong
- Marilyn Laughlin
- James Lawrence
- Leavitt Medical Associates of Florida Inc
- Angela J Lee
- Donna Liegel
- Kenneth H Lucas
- Patrick Lupton
- Chad Magilke
All providers in Heathrow, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.