JOHN LEWIS LEAKE
NPI 1114600780
Physician Assistant in Fort Worth, TX

Q: What is John Leake's NPI number?

The NPI number for John Leake is 1114600780. It was assigned to this individual provider in the NPPES registry on August 10, 2023.

Q: What is John Leake's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for John Leake was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 10, 2023PECOS EnrolledAccepts Medicare Assignment

800 5TH AVE STE 300, FORT WORTH, TX 76104(817) 250-6575(817) 250-0109 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 20, 2026, Mar 20, 2026, Aug 15, 2025 and 2 more (5 updates tracked since 2023).

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About John Lewis Leake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHN LEWIS LEAKE (NPI 1114600780) is an individual physician assistant in Fort Worth, Texas, licensed in Utah (14199280-1206) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS, is affiliated with Texas Health Harris Methodist Hospital Fort Worth, and maintains a secondary practice location in Grand Forks.

NPPES Registry Identity

NPI1114600780

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJOHN LEWIS LEAKE

Location Address800 5TH AVE STE 300Fort Worth, TX 76104-7303

Mailing AddressPo Box 5210Grand Forks, ND 58206-5210

Phone(817) 250-6575

Fax(817) 250-0109

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 10, 2023

Last NPPES UpdateApril 20, 20265 updates tracked since enumeration

NPPES CertifiedApril 20, 2026

✔ NPI 1114600780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in UT · 14199280-1206

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA19359 (TX)

800 5TH AVE STE 300, Fort Worth, TX 76104

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Secondary Practice Location 1

Location 13674 S Washington StGrand Forks, ND 58201-5766 · Phone (701) 205-3000 · Fax (701) 732-2501

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

John Lewis Leake is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3072020379

PECOS Enrollment IDI20250730003166

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Texas Health Harris Methodist Hospital Fort Worth

Acute Care Hospitals · Fort Worth, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number450135

Location1301 Pennsylvania AvenueFort Worth, TX 76104 · Tarrant County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$70.45 typical visit price

range $18.18 – $139.68

Typical copayment $17.61 (range $4.54 – $34.92)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNA BROOKLYN MOORE

Physician Assistant (Surgical)