Individual provider Active NPI

Logan Kahleb Leon, PA-C

  • Physician Assistant
  • Strongsville, OH
National Provider Identifier
1770104408
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50009402RX Issued in OH
Practice address
17406 Royalton Rd Ste B
Strongsville, OH 44136-5144
Phone
(440) 472-0900
Fax
(440) 472-0902
NPI assigned
May 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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 50009402RX OH Primary

Addresses

Primary practice location

17406 Royalton Rd Ste B
Strongsville, OH 44136-5144

Mailing address

1225 Township Road 1453
Ashland, OH 44805-9359
Phone (419) 908-8012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241105001544 NC Practitioner - Physician Assistant 9830623438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Sep 16, 2024 Accepting new patients
Emergeortho PA Physician Assistant CurrentSince Sep 16, 2024 Accepting new patients

Locations

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

5220 Oleander Dr
Fl 2
Wilmington, NC 28403
Phone (910) 395-8333

5220 Oleander Dr
Wilmington, NC 28403
Phone (910) 395-8333

Interoperability endpoints

  • Direct secure messaging: logan.leon.1@19801.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1770104408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 TOWNSHIP ROAD 1453",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448059359",
            "telephone_number": "419-908-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17406 ROYALTON RD STE B",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441365144",
            "telephone_number": "440-472-0900",
            "fax_number": "440-472-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "LOGAN",
        "middle_name": "KAHLEB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50009402RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.