Individual provider Active NPI

Jason A Leader, PA

  • Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1841529591
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9101468 Issued in FL
Practice address
603 N Flamingo Rd
Suite 258
Pembroke Pines, FL 33028-1023
Phone
(954) 430-2343
Fax
(954) 438-2983
NPI assigned
Dec 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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 PA 9101468 FL Primary

Addresses

Primary practice location

603 N Flamingo Rd
Suite 258
Pembroke Pines, FL 33028-1023

Mailing address

603 N Flamingo Rd
Suite 258
Pembroke Pines, FL 33028-1023
Phone (954) 430-2343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100414000974 FL Practitioner - Physician Assistant 8123155652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

603 N Flamingo Rd
Suite 258
Pembroke Pines, FL 33028-1013
Phone (954) 430-2343

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.82 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 9101468FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc Physician Assistant CurrentSince Jul 1, 2012 Accepting new patients
South Broward Surgical Group LLC Past Accepting new patients

Locations

4200 Washington St
Hollywood, FL 33021
Phone (954) 981-6300

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 4

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 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": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260316800000",
    "number": "1841529591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "SUITE 258",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281023",
            "telephone_number": "954-430-2343",
            "fax_number": "954-438-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N FLAMINGO RD",
            "address_2": "SUITE 258",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281023",
            "telephone_number": "954-430-2343",
            "fax_number": "954-438-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEADER",
        "first_name": "JASON",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9101468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.