Individual provider Active NPI

Jennifer Leizerovich, PA-C

  • Physician Assistant
  • Stuart, FL
National Provider Identifier
1689147795
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119835 Issued in FL
Practice address
1111 SE Federal Hwy Ste 334
Stuart, FL 34994-3839
Phone
(239) 690-6906
Fax
(772) 210-7559
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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 PA9119835 FL Primary

Addresses

Primary practice location

1111 SE Federal Hwy Ste 334
Stuart, FL 34994-3839

Mailing address

1111 SE Federal Hwy Ste 334
Stuart, FL 34994-3839
Phone (239) 690-6906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251125002746 FL Practitioner - Physician Assistant 7012409139 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

Practice addresses (Care Compare)

1111 SE Federal Hwy 334
Elite Dna Stuart
Stuart, FL 34994-3839
Phone (772) 210-7554

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9119835FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Nov 10, 2025 Accepting new patients
Mindful Medical and Health Services LLC CurrentSince Aug 18, 2025 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Nov 10, 2025 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

145 NW Central Park Plz
Ste 200
Port St Lucie, FL 34986
Phone (772) 303-1987

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

1111 SE Federal Hwy
Ste 334
Stuart, FL 34994
Phone 2396906906 ext. 21659

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1689147795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SE FEDERAL HWY STE 334",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943839",
            "telephone_number": "239-690-6906",
            "fax_number": "772-210-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SE FEDERAL HWY STE 334",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943839",
            "telephone_number": "239-690-6906",
            "fax_number": "772-210-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIZEROVICH",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.