Mark Jonathon Leach, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9101548 Issued in FL

Practice address

600 Village Square Xing
Palm Beach Gardens, FL 33410-4542

Phone

(561) 694-9493

Fax

(561) 694-9064

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Sebring Hospital, Sebring, FL, CCN 100109

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: mleach@aquadermatology.emadirect.md

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.

• Aqua Dermatology of Florida, PA

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1538270335
  Medicare reassignment Care Compare group
• Water'S Edge Dermatology, LLC

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1134148992
  Medicare reassignment NPD
• Naples Center for Dermatology & Riverchase Dermatology

  • Durable Medical Equipment & Medical Supplies
  • Cape Coral, FL
  • NPI 1538645775
  NPD
• Adult and Geriatric Institute of FL

  • Specialist
  • Ft Lauderdale, FL
  • NPI 1235179987
  NPD (past)

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

• Adventist Health System-Sunbelt Inc

  • General Acute Care Hospital
  • Sebring, FL
  • NPI 1083692594
  Care Compare affiliation

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1699720763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104542",
            "telephone_number": "561-694-9493",
            "fax_number": "561-694-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104542",
            "telephone_number": "561-694-9493",
            "fax_number": "561-694-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "MARK",
        "middle_name": "JONATHON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "PA9101548",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mleach@directaddress.net",
            "affiliation": "N",
            "address_1": "600 Village Square Xing",
            "city": "Palm Beach Gardens",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334104542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Simisola Olatokunbo Lawal
• Lawrence Lottenberg MD PA
• Bailey Lawrence, RN
• Robert Lee Lawrence, DC
• Brian Lazio
• Ricardo A. Leano, MD
• Antonella Restivo Leary, MD
• Hugh R Leavell, PH.D.
• Matthew Leber
• Patrick Leconte, D.M.D.

• Medical Physician Assistant in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.