Individual provider Active NPI

Jamie Joanne Le, PA-C

  • Surgical Physician Assistant
  • Willow Grove, PA
National Provider Identifier
1477994564
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
MA056248 Issued in PA
Practice address
2400 Maryland Rd
Suite 20
Willow Grove, PA 19090
Phone
(215) 830-8700
Fax
(215) 830-8715
NPI assigned
Jul 17, 2013
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA056248 PA Primary

Addresses

Primary practice location

2400 Maryland Rd
Suite 20
Willow Grove, PA 19090

Mailing address

833 Chestnut St Ste 520
Philadelphia, PA 19107-4414
Phone (215) 830-8700

Other identifiers 1

IdentifierTypeStateIssuer
MA056248OtherPASTATE LICENSURE

Other names 1

  • Jamie Joanne Bair Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20131213001143 PA Practitioner - Physician Assistant 5395972574 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA056248PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jan 1, 2016 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Jan 1, 2016 Accepting new patients

Locations

1200 Manor Dr
Chalfont, PA 18914
Phone (215) 830-8700

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

2400 Maryland Rd
Ste 20
Willow Grove, PA 19090
Phone (215) 830-8700

Organizations & group practices 2

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1477994564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 520",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074414",
            "telephone_number": "215-830-8700",
            "fax_number": "267-339-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MARYLAND RD",
            "address_2": "SUITE 20",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "19090",
            "telephone_number": "215-830-8700",
            "fax_number": "215-830-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "JAMIE",
        "middle_name": "JOANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA056248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "MA056248",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "BAIR",
            "middle_name": "JOANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.