Individual provider Active NPI

Eric Wayne Leach, PA-C

  • Medical Physician Assistant
  • Tulsa, OK
National Provider Identifier
1962733808
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1871 Issued in OK
Practice address
5801 E 41St St Ste 900
Tulsa, OK 74135-5631
Phone
(918) 747-4975
Fax
(918) 743-8552
NPI assigned
Jan 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1871 OK Primary

Addresses

Primary practice location

5801 E 41St St Ste 900
Tulsa, OK 74135-5631

Mailing address

PO Box 4930
Tulsa, OK 74159-0930
Phone (918) 747-4975

Other identifiers 1

IdentifierTypeStateIssuer
200279490AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20100216000347 OK Practitioner - Physician Assistant 2466596366 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Consultants of Tulsa, Inc.Group PAC ID 0648269324, 34 clinicians

Practice addresses (Care Compare)

5801 E 41St St
Suite 900
Tulsa, OK 74135-5631
Phone (918) 743-8838

Hospital & facility affiliations

  • Saint Francis Hospital, Inc Hospital, Tulsa, OK, CCN 370091
  • Saint Francis Hospital South, LLC Hospital, Tulsa, OK, CCN 370218

Merit-based Incentive Payment System (MIPS)

Final score
77.65 of 100Reported as group
Quality
92.54
Improvement activities
40
Cost
39.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1871OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Oct 2, 2017 Accepting new patients
St. John Physicians, Inc. CurrentSince Oct 2, 2017 Accepting new patients
Tulsa Radiology Associates Inc PastSince Jul 1, 2009 Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients

Locations

12451 E 100th St N
Owasso, OK 74055
Phone (918) 274-5000

1004 E Bryan Ave
Sapulpa, OK 74066
Phone (918) 224-4280

1717 S Utica Ave
Ste A
Tulsa, OK 74104
Phone (918) 748-1300

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

1923 S Utica Ave
Tulsa, OK 74104
Phone (918) 744-2345

Organizations & group practices 6

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 3

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": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1962733808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4930",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741590930",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 E 41ST ST STE 900",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355631",
            "telephone_number": "918-747-4975",
            "fax_number": "918-743-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "ERIC",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-15",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279490A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.