Individual provider Active NPI

Brittany Jean Leatherwood, PA

  • Physician Assistant
  • Humble, TX
National Provider Identifier
1992429559
Registry record updated Jun 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16026 Issued in TX
Practice address
18980 W Memorial Dr Ste 300
Humble, TX 77338-4559
Phone
(281) 548-2626
NPI assigned
Sep 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA16026 TX Primary

Addresses

Primary practice location

18980 W Memorial Dr Ste 300
Humble, TX 77338-4559

Mailing address

10740 N Gessner Rd Ste 310
Houston, TX 77064-1240
Phone (281) 897-0416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240606002105 TX Practitioner - Physician Assistant 3870035744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical Branch at Galveston, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ear, Nose and Throat Specialists, PLLCGroup PAC ID 5799770202, 123 clinicians

Practice addresses (Care Compare)

7900 Fannin St
Suite 1900
Houston, TX 77054-2934
Phone (713) 791-9363

9301 Pinecroft Dr
Suite 150
Shenandoah, TX 77380-3182
Phone (281) 362-1368

Hospital & facility affiliations

  • Memorial Hermann Northeast Hospital Hospital, Humble, TX, CCN 450684

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area ENT Specialists LLP Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Transcendent Industries LLC Single Specialty PastSince Oct 1, 2022 Accepting new patients

Locations

333 N Texas Ave
Ste 3100
Webster, TX 77598
Phone (281) 338-7135

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADGEAA

Organizations & group practices 3

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": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1992429559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 N GESSNER RD STE 310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641240",
            "telephone_number": "281-897-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18980 W MEMORIAL DR STE 300",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384559",
            "telephone_number": "281-548-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERWOOD",
        "first_name": "BRITTANY",
        "middle_name": "JEAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.