Mallory Leblanc

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

9119379 Issued in FL

Practice address

6931 W Broward Blvd
Plantation, FL 33317-2902

Phone

(954) 321-5191

NPI assigned

Jan 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Medical Center IncGroup PAC ID 2365521788, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Urgent Medical Center Inc

  • Urgent Care Clinic/Center
  • Plantation, FL
  • NPI 1609098250
  Medicare reassignment Care Compare group
• Chiro Worx Injury Center Inc

  • Primary Care Clinic/Center
  • Plantation, FL
  • NPI 1801524459
  NPD
• Medi Partners of South Florida, LLC

  • Clinic/Center
  • Miami Shores, FL
  • NPI 1922241579
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1497469282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172902",
            "telephone_number": "954-321-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10000 Stirling Rd Ste 7",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330248067",
            "country_code": "US",
            "telephone_number": "954-589-5169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9600 NE 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Miami Shores",
            "state": "FL",
            "postal_code": "331382722",
            "country_code": "US",
            "telephone_number": "305-603-7650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9119379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam James Lazarus, MD
• Tam Le, MD
• Leann Dehoff, PHD, LMHC, Inc.
• Leanna Rachel Levin, LMHC, PA
• Leap Pediatric Therapy and Sports Medicine PLLC
• Dafna Lebow, MD
• Jared M Lechtenstein, D.O.
• Anesia Lee
• Chee Khoon Lee, ARNP
• Felicia Ryan Lee

• Medical Physician Assistant in Plantation, FL
• Providers in Plantation, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.

Verify at the official NPI Registry.