MS. LISA LEEDHAM PA-C
NPI 1881143022
Physician Assistant in Cloquet, MN

Q: What is Lisa Leedham's NPI number?

The NPI number for Lisa Leedham is 1881143022. It was assigned to this individual provider in the NPPES registry on September 29, 2016.

Q: What is Lisa Leedham'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 Lisa Leedham was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 September 29, 2016PECOS EnrolledAccepts Medicare Assignment

512 SKYLINE BLVD, CLOQUET, MN 55720(218) 879-4641(218) 879-9167 Get Directions Write a Review

NPPES record last updated: June 18, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 9, 2020, Mar 17, 2018, Nov 13, 2017 and 1 more (4 updates tracked since 2016).

On this page

About Ms. Lisa Leedham Pa-c NPPES

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

MS. LISA LEEDHAM PA-C (NPI 1881143022) is an individual physician assistant in Cloquet, Minnesota, licensed in Minnesota (12573) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS, is affiliated with Cook Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1881143022

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMS. LISA LEEDHAMCredential: PA-C

Location Address512 SKYLINE BLVDCloquet, MN 55720-3787

Mailing Address512 Skyline BlvdCloquet, MN 55720-1199 · (218) 879-4641 · Fax (218) 879-9167

Phone(218) 879-4641

Fax(218) 879-9167

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateSeptember 29, 2016

Last NPPES UpdateJune 18, 20264 updates tracked since enumeration

NPPES CertifiedJune 18, 2026

✔ NPI 1881143022 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 MN · 12573

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 · MedicalTaxonomy 363AM0700X · License 5601007983 (MI)

512 SKYLINE BLVD, Cloquet, MN 55720

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Security Health Plan.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

Ms. Lisa Leedham Pa-c 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 ID9335437888

PECOS Enrollment IDI20171031001225

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 2

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

Cook Hospital

Critical Access Hospitals · Cook, MN

OwnershipGovernment - Hospital District or Authority

CMS Certification Number241312

Location10 SE Fifth StCook, MN 55723 · St. Louis County

Emergency services

Community Memorial Hospital

Critical Access Hospitals · Cloquet, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number241364

Location512 Skyline BoulevardCloquet, MN 55720 · Carlton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55720 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$23.99 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

COMMUNITY MEMORIAL HOSPITAL ASSOCIATION

General Acute Care Hospital (Critical Access)