Leah Gustavson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005119 Issued in NY

Practice address

763 Larkfield Rd
Commack, NY 11725-3131

Phone

(631) 462-2225

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State University of New York at Stony Brook, School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

Merit-based Incentive Payment System (MIPS)

Final score

90.8 of 100Reported as group

Quality

91.79

Promoting interoperability

100

Improvement activities

40

Cost

75.18

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: lgustavson501418@nyumc.direct-ci.com

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.

• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group NPD
• Brookhaven Memorial Hospital Medical Center, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Patchogue, NY
  • NPI 1417232760
  Medicare reassignment
• Long Island Spine Specialists PC

  • Orthopaedic Surgery of the Spine Physician
  • Commack, NY
  • NPI 1245251198
  Medicare reassignment
• Brookhaven Memorial Hospital Medical Center, Inc.

  • Psychiatry Physician
  • Patchogue, NY
  • NPI 1346429115
  NPD
• Long Island Community Hospital at NYU Langone Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shirley, NY
  • NPI 1902029796
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD
• Tenet-Solantic Joint Venture LLC

  • Urgent Care Clinic/Center
  • West Palm Beach, FL
  • NPI 1104159755
  NPD (past)

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

• NYU Langone Hospitals

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Patchogue, NY
  • NPI 1013724061

  Hospital

  Care Compare affiliation
• NYU Langone Hospitals

  • General Acute Care Hospital
  • Patchogue, NY
  • NPI 1831910355
  Care Compare affiliation

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1730197773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 LARKFIELD RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253131",
            "telephone_number": "631-462-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 LARKFIELD RD",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253131",
            "telephone_number": "631-462-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAVSON",
        "first_name": "LEAH",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005119",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9105115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saurabh Gupta, MD
• Alexander Nichoals Gurico, INTERN CANDIDATE MSW
• Gurwin Home Care Agency, Inc.
• Gurwin Jewish Geriatric Center
• Gurwin Jewish Nursing & Rehab Center
• Shari Haber, M.S. L.SP.
• Brian James Haensly, LCSW-R
• Gary M Hahn, M.D.
• Ann Margaret Hajduk-Bennett, DO
• Jennifer Hajek

• Physician Assistant in Commack, NY
• Providers in Commack, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; 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.