LEAH ELIZABETH GONNEVILLE PA-C
NPI 1902552102
Physician Assistant in Chicago, IL

Active since February 25, 2022PECOS EnrolledAccepts Medicare Assignment
1642 N MARSHFIELD AVE APT 2R, CHICAGO, IL 60622(207) 436-5078 Get Directions Write a Review

NPPES record last updated: May 20, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 20, 2022, Feb 25, 2022 (2 updates tracked since 2022).

About Leah Elizabeth Gonneville Pa-c NPPES

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

LEAH ELIZABETH GONNEVILLE PA-C (NPI 1902552102) is an individual physician assistant in Chicago, Illinois, licensed in Illinois (085008942) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS, is affiliated with Roseland Community Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1902552102
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLEAH ELIZABETH GONNEVILLECredential: PA-C
Location Address1642 N MARSHFIELD AVE APT 2RChicago, IL 60622-1445
Mailing Address1642 N Marshfield Ave Apt 2rChicago, IL 60622-1445 · (207) 436-5078
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 25, 2022
Last NPPES UpdateMay 20, 20222 updates tracked since enumeration
NPPES CertifiedMay 20, 2022
NPI 1902552102 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 IL · 085008942
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.

1642 N MARSHFIELD AVE APT 2R, Chicago, IL 60622

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

Leah Elizabeth Gonneville 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 ID4688059249
PECOS Enrollment IDI20220916003252
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
23 services23 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Roseland Community Hospital

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140068
Location45 W 111th StreetChicago, IL 60628 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60622 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902552102, enumerated as an "individual" on February 25, 2022.

The provider is located at 1642 N MARSHFIELD AVE APT 2R CHICAGO, IL 60622 and the phone number is (207) 436-5078.

Physician Assistant with taxonomy code 363A00000X.

Leah Gonneville is affiliated with: ROSELAND COMMUNITY HOSPITAL.