LEIGH PAVLIK (NPI# 1184015497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184015497 |
| Entity Type | Individual |
| Full Name | LEIGH PAVLIK |
| Credential | PA-C |
| Practice Address |
4320 E. Presidio Street #101 Mesa AZ 85215-3031 |
| Mailing Address |
5155 E. Eagle Drive #20730 Mesa AZ 85277-3031 |
| Practice Telephone | 4807069430 |
| Practice Fax Number | 4803782273 |
| Mailing Telephone | 4807069430 |
| Mailing Fax Number | 4803782273 |
| Enumeration Date | 2015-02-09 |
| Last Update Date | 2016-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
AZ | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
5984 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5984 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 109236 | 05 |
| Street Address |
4320 E. PRESIDIO STREET #101 |
| City | MESA |
| State | AZ |
| Zip Code | 85215-3031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124002308 | Richard Paul De Rosa | Surgery | 4320 E. Presidio Street, #101, Mesa, AZ 85215-1165 | 2005-12-01 |
| 1942726047 | Tara Thompson | Physician Assistant | 4320 E. Presidio Street, #101, Mesa, AZ 85215-1165 | 2017-08-21 |
| 1467406264 | Melanie Denise Deyoung | Physician Assistant | 4320 E. Presidio Street, #101, Mesa, AZ 85215-1165 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093355356 | Kristen Eldridge | Counselor | 2929 N. Power Rd. Suite 101, Mesa, AZ 85215 | 2020-01-14 |
| 1063062149 | Makenna Francis | Nurse Practitioner | 2730 S. Val Vista Dr, 146, Mesa, AZ 85215 | 2019-09-19 |
| 1487200481 | Royalty Home Care Solutions, LLC | Assisted Living Facility | 6551 E. Menlo St, Mesa, AZ 85215 | 2019-08-15 |
| 1083170641 | Mylena Dashaun Smith | Psychologist | 2812 N. Norwalk St Bldg. 14, Ste 127 & 128, Mesa, AZ 85215 | 2019-02-19 |
| 1487134789 | Arizona Dental Professionals, P.C. | Dentist | 3218 N Recker Rd, Mesa, AZ 85215 | 2018-08-16 |
| 1619463494 | Compassion Care Home, LLC | Private Vehicle | 2863 N 64th Street, Mesa, AZ 85215 | 2018-07-05 |
| 1407293491 | Courtney D Warren | Physical Therapist | 2837 N Power Rd Ste 109, Mesa, AZ 85215 | 2013-05-30 |
| 1104182906 | Kirstin Anna Correia | Naturopath | 3405 N Higley Rd, Mesa, AZ 85215 | 2012-04-05 |
| 1154609683 | Cristy Lee Hoge | Pharmacist | 2151 N. Power Rd., Mesa, AZ 85215 | 2011-08-02 |
| 1699067546 | Fredrick G. Johnson | Registered Nurse | 4320 E Presidio St, #101, Mesa, AZ 85215 | 2011-05-11 |
| Find all providers in zip 85215 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
| 1114325677 | John David Shull Jr. | Physician Assistant | 1520 S Dobson Rd Ste 305, Mesa, AZ 85202 | 2014-12-16 |
| 1679826051 | Az Richardson Surgical Services, LLC | Physician Assistant | 6417 E Star Valley St, Mesa, AZ 85215-0891 | 2012-10-22 |
| 1508173014 | Karli Elizabeth Vierra | Physician Assistant | 1450 S Dobson Rd Ste 320b, Mesa, AZ 85202-4765 | 2010-09-03 |
| 1023335627 | Shawn Christopher Smith | Physician Assistant | 1432 S. Dobson Road, Suite 501, Mesa, AZ 85202 | 2010-04-23 |
| 1144460221 | April M Cadreau | Physician Assistant | 5235 E Southern Ave Ste D106-159, Mesa, AZ 85206 | 2009-03-02 |
| 1598987505 | Patricia Kim Brown | Physician Assistant | 1002 E. Sorenson St., Mesa, AZ 85203 | 2007-05-02 |
| 1275632788 | Justina D Alphin | Physician Assistant | 7525 E Broadway Rd Ste 3, Mesa, AZ 85208-1156 | 2006-09-21 |
| 1750390803 | Daniel Stephen Blake | Physician Assistant | 1839 E Enrose St, Mesa, AZ 85203-5822 | 2006-08-07 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.