Active NPI
Leisha Anne Bevoni, PA-C
- Physician Assistant
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA03861
- 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, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04257 | Medicaid | NM |
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
Enrollment records 1
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 100
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PA2002-0001 | NM | MD | Endocrinology, Diabetes & Metabolism Physician |
| PA03861 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Current | 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
- 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.
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1760452767
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba UT Southwestern University Hospital
- General Acute Care Hospital
- Dallas, TX
- NPI 1285798918
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": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.