NPIMap

Individual provider Active NPI

Michael Leonard, PA-C

  • Physician Assistant
  • Robbinsdale, MN
National Provider Identifier
1831511484
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2024 Issued in MN
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone
(763) 520-3917
NPI assigned
Jan 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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 2024 MN Primary

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Mailing address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-3917

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150127001145 SD Practitioner - Physician Assistant 8527298256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

6100 S Louise Ave
Sioux Falls, SD 57108-6029

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024MNMDMarriage & Family Therapist
11523MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Dec 8, 2014 Accepting new patients
Sanford Clinic CurrentSince Dec 8, 2014 Accepting new patients
Avera McKennan CurrentSince Nov 28, 2022 Accepting new patients
Avera McKennan CurrentSince Nov 28, 2022 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

2042 Juniper Ave
Slayton, MN 56172
Phone (507) 836-1227

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

6100 S Louise Ave
Ste 1500
Sioux Falls, SD 57108
Phone (605) 504-1100

6800 S Louise Ave
Sioux Falls, SD 57108
Phone (605) 322-3278

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

6100 S Louise Ave
Ste 2100
Sioux Falls, SD 57108
Phone (605) 504-1100

1600 S Highline Ave
Ste 110
Sioux Falls, SD 57110
Phone (605) 504-5670

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

600 N Sycamore Ave
Sioux Falls, SD 57110
Phone (605) 328-2999

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

Organizations & group practices 7

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1831511484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "2024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.