NPIMap

Individual provider Active NPI

Leo Sillick, PA-C

  • Medical Physician Assistant
  • Coudersport, PA
National Provider Identifier
1619013083
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA052864 Issued in PA
Practice address
1001 E 2ND St
Coudersport, PA 16915-8161
Phone
(814) 274-9300
NPI assigned
Jan 30, 2007
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA052864 PA Primary

Addresses

Primary practice location

1001 E 2ND St
Coudersport, PA 16915-8161

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsillick231662@upmc.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140416000044 PA Practitioner - Physician Assistant 7012918840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles Cole Memorial HospitalGroup PAC ID 3779487475, 66 clinicians

Practice addresses (Care Compare)

1001 E 2ND St
Coudersport, PA 16915-8161

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
75.14
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA052864PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Cole Memorial Hospital CurrentSince Dec 11, 2013 Accepting new patients
Charles Cole Memorial Hospital CurrentSince Aug 1, 2007 Accepting new patients
Charles Cole Memorial D/B/a Upmc Cole CurrentSince Aug 1, 2007 Accepting new patients
Charles Cole Memorial Hospital D/B/a Upmc Cole Past Accepting new patients

Locations

1001 E 2nd St
Coudersport, PA 16915
Phone (814) 274-7407

438 E 2nd St
Coudersport, PA 16915
Phone (814) 274-5252

Interoperability endpoints

  • Direct secure messaging: leo.t.sillick@upmcdirect.com
  • Direct secure messaging: lsillick231662@upmc.direct-ci.com

Organizations & group practices 4

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 6

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1619013083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLICK",
        "first_name": "LEO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2026-09-16",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsillick231662@upmc.direct-ci.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coudersport, PA

Sources for this page

Verify at the official NPI Registry.