| Leap Pediatric And Adolescent Care | |
|
1747 Summit Ave Saint Paul MN 55105-1833 | |
| (651) 242-2849 | |
| Not Available |
| Full Name | Leap Pediatric And Adolescent Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1747 Summit Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | Julia Joseph-di Caprio (PRESIDENT AND FOUNDER) |
| Authorized Official Contact | 6512422849 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leap Pediatric And Adolescent Care 1747 Summit Ave Saint Paul MN 55105-1833 Ph: (651) 242-2849 | Leap Pediatric And Adolescent Care 1747 Summit Ave Saint Paul MN 55105-1833 Ph: (651) 242-2849 |
| NPI Number | 1457082919 |
|---|---|
| Provider Enumeration Date | 06/23/2022 |
| Last Update Date | 06/27/2022 |
| Medicare PECOS PAC ID | 4284002106 |
|---|---|
| Medicare Enrollment ID | O20221128002092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457082919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Julia P Joseph-dicaprio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164433454 PECOS PAC ID: 9234033820 Enrollment ID: I20051027000115 |
| Provider Name | Paul F Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194761544 PECOS PAC ID: 1052477619 Enrollment ID: I20090305000452 |
| Provider Name | Peter B Scal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619077484 PECOS PAC ID: 2567654981 Enrollment ID: I20101004001160 |
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