NPIMap

Individual provider Active NPI

Leah Marie Medure, MS, PA-C

  • Physician Assistant
  • Bloomington, MN
National Provider Identifier
1508958364
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004814 Issued in MI
Practice address
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone
(952) 835-9880
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004814 MI Primary

Addresses

Primary practice location

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435

Mailing address

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140327001579 OR Practitioner - Physician Assistant 2062413768 Reassigns benefits to 2 organizations
I20210922000483 MN Practitioner - Physician Assistant 2062413768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1159 County Rd E E
Vadnais Heights, MN 55110-5183
Phone (651) 789-6500

3010 Denmark Ave
Eagan, MN 55121-2271
Phone (651) 789-9900

4300 Marketpointe Dr
Suite 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

7115 Tamarack Rd
Suite 150
Woodbury, MN 55125-1208
Phone (651) 789-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Professional Association CurrentSince Nov 1, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Dec 26, 2019 Accepting new patients
Emergency Physicians Professional Association CurrentSince Nov 1, 2021 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Dec 26, 2019 Accepting new patients

Locations

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

475 S Columbia River Hwy
Ste 105
Saint Helens, OR 97051
Phone (503) 397-7119

500 N Columbia River Hwy
Ste 6
Saint Helens, OR 97051
Phone (503) 366-5101

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1508958364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDURE",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.