Individual provider Active NPI

Michael Scott Leon, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1679978522
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1566 Issued in NV
Practice address
500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084
Phone
(702) 259-1228
NPI assigned
Nov 4, 2014
Last updated
Nov 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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 PA1566 NV Primary

Addresses

Primary practice location

500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084

Mailing address

500 N Rainbow Blvd Ste 203
Las Vegas, NV 89107-1084
Phone (702) 259-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150203000028 NV Practitioner - Physician Assistant 5092030635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Irv Edwards MD PCGroup PAC ID 2365926698, 33 clinicians

Practice addresses (Care Compare)

1050 W Galleria Dr
Henderson, NV 89011-4800
Phone (702) 963-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1566NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC CurrentSince Dec 1, 2014 Accepting new patients
Doctors Medical Services, Emcare Past Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

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.

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1679978522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084",
            "telephone_number": "702-259-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N RAINBOW BLVD STE 203",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891071084",
            "telephone_number": "702-259-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.