Leah Elizabeth Gonneville, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085008942 Issued in IL

Practice address

1642 N Marshfield Ave Apt 2R
Chicago, IL 60622-1445

Phone

(207) 436-5078

NPI assigned

Feb 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roseland Community Hospital Hospital, Chicago, IL, CCN 140068

Merit-based Incentive Payment System (MIPS)

Final score

93.41 of 100Reported as group

Quality

86.81

Improvement activities

40

Cost

77.34

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment
• Great Lakes Emergency Physicians Medical Group SC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1689212581
  Medicare reassignment
• New Rose Healthcare Management LLC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1043816515
  Medicare reassignment
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Hoffman Estates, IL
  • NPI 1447873740
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

• Roseland Community Hospital Association

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1568472819
  Care Compare affiliation

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1902552102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 N MARSHFIELD AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221445",
            "telephone_number": "207-436-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 N MARSHFIELD AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221445",
            "telephone_number": "207-436-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONNEVILLE",
        "first_name": "LEAH",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shunyou Gong, M.D.
• Divyasri Gongireddy
• Bridget Gongol, MD
• Dmitriy Gonikman
• Reem Gonnah, MD
• Abigail Gonsalves
• Nirmala Gonsalves, MD
• Shirley Gonsalves
• Katherine M Gonsch, PT, DPT
• Michael J Gontarek, DC

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.