Individual provider Active NPI

Carly Rose Leventoff, PA-C

  • Physician Assistant
  • Dover, DE
National Provider Identifier
1659103182
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
640 S State St
Dover, DE 19901-3530
Phone
(302) 674-4700
NPI assigned
Aug 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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 Primary

Addresses

Primary practice location

640 S State St
Dover, DE 19901-3530

Mailing address

PO Box 252
South Fallsburg, NY 12779-0252
Phone (845) 807-8547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20241121004683 DE Practitioner - Physician Assistant 4486189800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Emergency Physicians LLCGroup PAC ID 7719240696, 80 clinicians

Practice addresses (Care Compare)

18383 Hudson Rd
Suite a
Milton, DE 19968-3103
Phone (302) 725-3500

640 S State St
Dover, DE 19901-3530

Hospital & facility affiliations

  • Bayhealth Hospital, Sussex Campus Hospital, Milford, DE, CCN 080009
  • Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

National Provider Directory

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1659103182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "city": "SOUTH FALLSBURG",
            "state": "NY",
            "postal_code": "127790252",
            "telephone_number": "845-807-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-674-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENTOFF",
        "first_name": "CARLY",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.