LESLIE ANN WEISS RUSSO (NPI# 1124540372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124540372 |
| Entity Type | Individual |
| Full Name | LESLIE ANN WEISS RUSSO |
| Credential | PA-C |
| Practice Address |
1700 W Paradise Dr West Bend WI 53095-9795 |
| Mailing Address |
1700 W Paradise Drive West Bend WI 53095-9795 |
| Practice Telephone | 2623343451 |
| Mailing Telephone | 2623343451 |
| Mailing Fax Number | 2623345321 |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2019-04-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1700 W PARADISE DR |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-9795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811980568 | Mark R Meuler | Optometrist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2005-08-29 |
| 1902405186 | Ashley Renee Miller | Physical Therapist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2020-10-20 |
| 1114552312 | Emily Hope Gorman | Registered Nurse | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2020-03-08 |
| 1992354823 | Froedtert Health Pharmacy LLC | Pharmacy | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-09-04 |
| 1184180994 | Jennifer Jean Schmidt | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-02-17 |
| 1770055782 | Lori Jo Dauss | Specialist/Technologist | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2019-01-02 |
| 1851808059 | Allison Danielle Kaczmarek | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2018-01-09 |
| 1306360409 | Jeremiah Christian Parve | Nurse Practitioner | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-07-31 |
| 1134656374 | Daniela Aleman | Family Medicine | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-05-18 |
| 1396285854 | Tejaswini Mirji-lakkundi | Dietitian, Registered | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2017-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396031274 | Colleen Elizabeth Gosa Nalepinski | Physician Assistant | 525 S Silverbrook Dr, West Bend, WI 53095-3868 | 2011-06-20 |
| 1295784072 | Infinity Healthcare Physicians, S.c. | Physician Assistant | St. Joseph's Community Hospital, 3200 Pleasant Valley Road, West Bend, WI 53095-9274 | 2006-05-09 |
| 1265885156 | Marion Robbins Gailey | Physician Assistant | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2016-07-15 |
| 1528203288 | Daniel J Nalepinski | Physician Assistant | 1190 E Paradise Dr, West Bend, WI 53095-5444 | 2008-12-10 |
| 1366524191 | Stephanie A Weiss | Physician Assistant | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2006-10-20 |
| 1407963713 | Randy L Purcell | Physician Assistant | 205 Valley Ave, West Bend, WI 53095-5312 | 2006-08-23 |
| 1437178944 | Margaret P Hays | Physician Assistant | 205 Valley Ave, West Bend, WI 53095-5312 | 2006-07-18 |
| 1336170562 | Scott Edward Mehlos | Physician Assistant | 1700 W Paradise Dr, West Bend, WI 53095-9795 | 2006-07-05 |
| 1164459640 | Amy L Haug | Physician Assistant | 205 Valley Ave, West Bend, WI 53095-5312 | 2006-06-28 |
| 1164475547 | Melissa Rae Schmidt | Physician Assistant | 205 Valley Ave, West Bend, WI 53095-5312 | 2006-05-18 |
| Find all providers in WEST BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.