Individual provider Active NPI

Carlyn Sara Leahey, PA

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1841567674
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60711668 Issued in WA
Practice address
1321 Colby Ave
Everett, WA 98201
Phone
(425) 261-2000
NPI assigned
Nov 22, 2011
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1099 AL
Physician Assistant 363A00000X 5055 AZ
Surgical Physician Assistant 363AS0400X 5055 AZ
Surgical Physician Assistant 363AS0400X 1099 AL
Physician Assistant 363A00000X PA60711668 WA Primary

Addresses

Primary practice location

1321 Colby Ave
Everett, WA 98201

Mailing address

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 635-6731

Other practice location 1

2451 Fillingim St
Mastin, Ste 101
Mobile, AL 36617-2238
Phone (251) 445-8282

Other practice location 2

1700 13th St
Everett, WA 98201-1689
Phone (425) 297-6400

Other identifiers 1

IdentifierTypeStateIssuer
663164MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170106001411 WA Practitioner - Physician Assistant 5496913147 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jan 30, 2017 Accepting new patients
Providence Health & Services-Washington CurrentSince Jan 30, 2017 Accepting new patients
Providence Health & Services-Washington CurrentSince Jan 30, 2017 Accepting new patients
University of South Alabama Current Accepting new patients
Providence Health & Services-Wa CurrentSince Jan 30, 2017 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jun 19, 2023 Accepting new patients
Sound Weight and Wellness PLLC Past Accepting new patients
Ucxtra Umbrella, LLC Past Accepting new patients

Locations

1660 Spring Hill Ave
Mobile, AL 36604
Phone (251) 445-9616

1660 Spring Hill Ave
Ste 3069
Mobile, AL 36604
Phone (251) 445-8405

2451 Fillingim St
Mobile, AL 36617
Phone (251) 434-3711

2451 Fillingim St
Ste 101
Mobile, AL 36617
Phone (251) 445-8282

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1231 116th Ave NE
Ste 515
Bellevue, WA 98004
Phone (425) 467-3957

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1700 13th St
Everett, WA 98201
Phone (425) 252-0895

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: cleahey775952@wm.providencedirect.org

Organizations & group practices 10

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": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1841567674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-635-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-261-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2451 Fillingim St",
            "address_2": "Mastin, Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366172238",
            "country_code": "US",
            "telephone_number": "251-445-8282",
            "fax_number": "251-445-8281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 13th St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011689",
            "country_code": "US",
            "telephone_number": "425-297-6400",
            "fax_number": "425-259-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAHEY",
        "first_name": "CARLYN",
        "middle_name": "SARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "1099",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5055",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "5055",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "1099",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60711668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "663164",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.