Individual provider Active NPI

Leah Bennett, PA-C

  • Surgical Physician Assistant
  • Flint, MI
National Provider Identifier
1508683772
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601012793 Issued in MI
Practice address
1 Hurley PLZ
Flint, MI 48503-5902
Phone
(810) 262-9000
NPI assigned
Sep 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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 5601012793 MI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5902

Mailing address

28341 Couzens Ave
Madison Heights, MI 48071-2964
Phone (248) 885-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20241120003914 MI Practitioner - Physician Assistant 8921533431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Central Michigan College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

1 Hurley Plasa
9W Hurley Maternal Fetal Medicine
Flint, MI 48503-5902
Phone (810) 262-4787

1 Hurley PLZ
Flint, MI 48503-5902

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601012793MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Hurley Medical Center CurrentSince Oct 1, 2024 Accepting new patients
Pathology Associates Inc PC Current Accepting new patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Oct 1, 2024 Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1 Hurley Plz
#7B
Flint, MI 48503
Phone (810) 262-9355

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1508683772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28341 COUZENS AVE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712964",
            "telephone_number": "248-885-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LEAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601012793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.