Individual provider Active NPI

Wade Karl Leavitt, PA-C

  • Physician Assistant
  • Logandale, NV
National Provider Identifier
1801786454
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0751 Issued in NV
Practice address
1925 Whipple Ave Ste 30
Logandale, NV 89021-9934
Phone
(702) 398-3621
NPI assigned
Jul 7, 2025
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0751 NV Primary
Physician Assistant 363A00000X PA3249 NV

Addresses

Primary practice location

1925 Whipple Ave Ste 30
Logandale, NV 89021-9934

Mailing address

1301 Bertha Howe Ave Ste 1
Mesquite, NV 89027-7503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20251030005017 NV Practitioner - Physician Assistant 6204325079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1925 Whipple Ave
Suite 30
Logandale, NV 89021-9934
Phone (702) 398-3621

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA0751NVMDPhysician Assistant
PA3249NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mesquite Clinic Management Company LLC CurrentSince Oct 7, 2025 Accepting new patients
Mesquite Clinic Management Company LLC CurrentSince Oct 7, 2025 Accepting new patients
Alfaro LTD Past Accepting new patients

Locations

1301 Bertha Howe Ave
Ste 1
Mesquite, NV 89027
Phone (702) 346-0200

Interoperability endpoints

  • Direct secure messaging: wade.leavitt.1@2184.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1801786454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BERTHA HOWE AVE STE 1",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890277503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 WHIPPLE AVE STE 30",
            "city": "LOGANDALE",
            "state": "NV",
            "postal_code": "890219934",
            "telephone_number": "702-398-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "WADE",
        "middle_name": "KARL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA0751",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA3249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logandale, NV

Sources for this page

Verify at the official NPI Registry.