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CARL WALLACE LEDER PA-C
NPI 1619341724
Physician Assistant in Roseburg, OR

Active since December 01, 2015PECOS Enrolled
621 W MADRONE ST, ROSEBURG, OR 97470(541) 672-2691(833) 299-8415 Get Directions Write a Review

NPPES record last updated: February 23, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 23, 2022, Dec 1, 2015 (2 updates tracked since 2015).

About Carl Wallace Leder Pa-c NPPES

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

CARL WALLACE LEDER PA-C (NPI 1619341724) is an individual physician assistant in Roseburg, Oregon, licensed in Oregon (PA174113) and active in the NPI registry since December 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619341724
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameCARL WALLACE LEDERCredential: PA-C
Location Address621 W MADRONE STRoseburg, OR 97470-3090
Mailing AddressPo Box 1121Roseburg, OR 97470-0254 · (541) 672-2691 · Fax (833) 299-8415
Phone(541) 672-2691
Fax(833) 299-8415
Sole ProprietorNo
Enumeration DateDecember 1, 2015
Last NPPES UpdateFebruary 23, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2022
✔ NPI 1619341724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in OR · PA174113
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.
621 W MADRONE ST, Roseburg, OR 97470
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Carl Wallace Leder Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97470 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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 20

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

WILLIAM F SHOBE JR. LMFT
Marriage & Family Therapist
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 492-4550
HEATHER IRENE JOHNSON MSW
Social Worker
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532
URIAH HEATH YRAGUEN
Peer Specialist
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MR. DALE EDWARD WILLIAMS MC, LPC
Counselor (Mental Health)
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532
EMILY TUCKER LPC NCC
Counselor (Professional)
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
INGER C BOYD MA ED., BS
Counselor
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532
MAE L HOOPES
Counselor (Addiction (Substance Use Disorder))
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
JENNIFER DIANE LOWRY
Counselor (Mental Health)
621 W MADRONE ST
ROSEBURG, OR 97470
Douglas County (541) 440-3532

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carl Leder's NPI number?

The NPI number for Carl Leder is 1619341724. It was assigned to this individual provider in the NPPES registry on December 1, 2015.

Where is Carl Leder located?

Carl Leder practices at 621 W Madrone St, Roseburg, OR 97470. The listed phone number is (541) 672-2691.

What is Carl Leder's specialty?

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

Is Carl Leder enrolled in Medicare?

Yes. Carl Leder is registered in the Medicare PECOS enrollment system.

What insurance does Carl Leder accept?

Health plans from Moda Health Plan, Inc. and PacificSource Health Plans list Carl Leder as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carl Leder was last updated on February 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.