Leonard Tyrone Mason, PA-C
Individual provider Active NPI Physician Assistant · Honolulu, HI
NPI 1912977455 · NPPES record last updated Jan 2, 2024
Key facts
- NPI
- 1912977455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA10003571 (WA)
- Practice address
- Tripler Army Medical Center
1 Jarrett White Road
Honolulu, HI 96859-5000 - Phone
- (808) 433-4720
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in FL, NC, WA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150821014653 | FL | Practitioner - Physician Assistant | 0446430086 | Reassigns benefits to 1 organization |
| I20180613002753 | NC | Practitioner - Physician Assistant | 0446430086 | |
| I20210604002781 | WA | Practitioner - Physician Assistant | 0446430086 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10003571 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current |
Accepting new patients | |
| Multicare Health System | Current |
Accepting new patients | |
| Ipn Emergency Physicians of North Florida PA | Physician Assistant | Past | Accepting new patients |
| Amelia Express Care, LLC | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
14815 Pacific Ave S
Tacoma, WA 98444
Phone (253) 697-8660
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10003571 | WA | Yes |
Addresses
Primary practice location
Tripler Army Medical Center
1 Jarrett White Road
Honolulu, HI 96859-5000
Mailing address
1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Other providers in Honolulu, HI
- Billie-Sade Mason
- Gregory Mason
- Jelan Mason
- Judith A. Mason
- Kai Mason
- Megan Danielle Mason
- Elijah Ray Massey
- Yoshua A Massin
- Mastercare Homehealth Inc
- Mastercare Inc
All providers in Honolulu, HI · Physician Assistant in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.