Individual provider Active NPI

Izabella Leguard, MPAS, PA-C

  • Medical Physician Assistant
  • Conneaut Lake, PA
National Provider Identifier
1962206607
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
12387 Conneaut Lake Rd
Conneaut Lake, PA 16316-4203
Phone
(814) 382-0221
Fax
(814) 382-0231
NPI assigned
Apr 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA Primary

Addresses

Primary practice location

12387 Conneaut Lake Rd
Conneaut Lake, PA 16316-4203

Mailing address

12387 Conneaut Lake Rd
Conneaut Lake, PA 16316-4203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250611001417 PA Practitioner - Physician Assistant 9931619699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians
Primary Care ServicesGroup PAC ID 0244452258, 32 clinicians

Practice addresses (Care Compare)

1012 Water St
Meadville, PA 16335-3468
Phone (814) 337-2345

12387 Conneaut Lake Rd
Conneaut Lake, PA 16316-4203
Phone (814) 373-4298

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meadville Physician Services Single Specialty Past Accepting new patients

Organizations & group practices 2

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 1

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": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1962206607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12387 CONNEAUT LAKE RD",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163164203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12387 CONNEAUT LAKE RD",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163164203",
            "telephone_number": "814-382-0221",
            "fax_number": "814-382-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGUARD",
        "first_name": "IZABELLA",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conneaut Lake, PA

Sources for this page

Verify at the official NPI Registry.