Individual provider Active NPI

Sarah Leiderman

  • Physician Assistant
  • Long Beach, CA
National Provider Identifier
1740639319
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA53454 Issued in CA
Practice address
320 Pine Ave Ste 1030
Long Beach, CA 90802-2366
Phone
(310) 360-7200
NPI assigned
Jun 6, 2016
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 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 PA53454 CA Primary

Addresses

Primary practice location

320 Pine Ave Ste 1030
Long Beach, CA 90802-2366

Mailing address

320 Pine Ave Ste 1030
Long Beach, CA 90802-2366
Phone (310) 360-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160819001662 CA Practitioner - Physician Assistant 9739474461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thomas Health Services IncGroup PAC ID 1355748021, 32 clinicians

Practice addresses (Care Compare)

320 Pine Ave
Suite 1030
Long Beach, CA 90802-2366
Phone (310) 360-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA53454CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens Medical Corporation CurrentSince Jun 23, 2024 Accepting new patients

Locations

320 Pine Ave
Ste 1030
Long Beach, CA 90802
Phone (310) 360-7200

Organizations & group practices 2

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1740639319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 PINE AVE STE 1030",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908022366",
            "telephone_number": "310-360-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 PINE AVE STE 1030",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908022366",
            "telephone_number": "310-360-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDERMAN",
        "first_name": "SARAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA53454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.