Individual provider Active NPI

Leisha Anne Bevoni, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1508956210
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03861 Issued in TX
Practice address
8611 Hillcrest Ave Ste 300
Dallas, TX 75225-4232
Phone
(214) 692-3100
Fax
(214) 692-3141
NPI assigned
Oct 13, 2006
Last updated
Aug 28, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03861 TX Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X PA2002-0001 NM
Endocrinology, Diabetes & Metabolism Physician 207RE0101X PA20020001 NM

Addresses

Primary practice location

8611 Hillcrest Ave Ste 300
Dallas, TX 75225-4232

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (469) 291-3372

Other practice location 1

2001 Inwood Rd Fl 8
Dallas, TX 75390-3180
Phone (214) 645-2800

Other identifiers 1

IdentifierTypeStateIssuer
04257MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140612000335 TX Practitioner - Physician Assistant 5092793547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2001 Inwood Rd
Dallas, TX 75390-7202

2201 Inwood Rd
Dallas, TX 75235-7320
Phone (214) 645-2700

5323 Harry Hines Blvd
Dallas, TX 75390-9257

5939 Harry Hines Blvd
Dallas, TX 75235-6246

8611 Hillcrest Ave
Dallas, TX 75225-4203
Phone (214) 692-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2002-0001NMMDEndocrinology, Diabetes & Metabolism Physician
PA03861TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 7, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 7, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

8611 Hillcrest Ave
Ste 300
Dallas, TX 75225
Phone (214) 645-8020

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Interoperability endpoints

  • Direct secure messaging: lbevoni168631@direct.swmed.us

Organizations & group practices 3

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1508956210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208",
            "telephone_number": "469-291-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 HILLCREST AVE STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752254232",
            "telephone_number": "214-692-3100",
            "fax_number": "214-692-3141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Inwood Rd Fl 8",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753903180",
            "country_code": "US",
            "telephone_number": "214-645-2800",
            "fax_number": "214-645-2828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEVONI",
        "first_name": "LEISHA",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03861",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NM",
            "license": "PA2002-0001",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NM",
            "license": "PA20020001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04257",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.