Active NPI
Leslie M Petosa, PAAA
- Anesthesiologist Assistant
- Atlanta, GA
National Provider Identifier
1487726501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 004924
- Practice address
- 303 Parkway Drive, NE
Box 404
Atlanta, GA 30312-1212 - Phone
- (404) 265-4520
- Fax
- (404) 265-3894
- NPI assigned
- Nov 14, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 004924 | GA | Primary |
Addresses
Primary practice location
303 Parkway Drive, NE
Box 404
Atlanta, GA 30312-1212
Mailing address
PO Box 932925
Atlanta, GA 31193-2925
Phone (800) 364-9216
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982637419 | Other | GA | GROUP NPI |
| N357715 | Other | GA | WELLCARE MEDICAID |
| P00418118 | Other | GA | RAILROAD MEDICARE |
| 1487726501 | Other | GA | NPI |
| 868831893A | Medicaid | GA |
Other names 1
- Leslie M Dean
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1487726501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932925",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311932925",
"telephone_number": "800-364-9216",
"fax_number": "423-892-5838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 PARKWAY DRIVE, NE",
"address_2": "BOX 404",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303121212",
"telephone_number": "404-265-4520",
"fax_number": "404-265-3894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETOSA",
"first_name": "LESLIE",
"middle_name": "M",
"credential": "PAAA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "GA",
"license": "004924",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1982637419",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE MEDICAID",
"identifier": "N357715",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00418118",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1487726501",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "868831893A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LESLIE",
"last_name": "DEAN",
"middle_name": "M",
"credential": "PAAA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.