LEAH TEDDER – Physician Assistant, NPI 1093045569

LEAH TEDDER is a healthcare provider. based in Destin, Florida. specializing in PHYSICIAN ASSISTANT. They hold a License No. 9105931 (FL). The NPI Number for LEAH TEDDER is 1093045569

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
LEAH TEDDER
NPI
1093045569
Phone
(808) 554-7640
Address
4242 JADE LOOP
Enumeration Date
6 January 2010
Last Update Date
12 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8507299468
Graduation Year
2010 (16 years ago)
PAC ID
7517130719
Group Practice PAC ID
9234596743
Professional Enrollment ID
I20111103000765
Address ID
FL325781045NI2190XNXXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:16State licenses:2Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for LEAH TEDDER

  • 4242 JADE LOOP

    DESTIN, FL 325415134

    Phone: (808) 554-7640

    Type: Mailing

  • Old Coastal Highway, Niceville, Okaloosa County, Florida, 32580, United States

    NICEVILLE, FL 325781045

    Phone: (850) 729-9490

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $470.

Total Amount is formed as General ($470) + Research ($0) + Ownership ($0) = $470.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Amgen Inc. ($205).

Total Amount

$470

General + Research + Ownership

Payments

5

Total payment records

General Amount

$470

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-11-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111103000765IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making148144$0
99283Emergency department visit with low level of medical decision making5048$0
99285Emergency department visit with high level of medical decision making4443$0
View full utilization report →

Insurance plans in this area (ZIP 32541)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234596743View full group profile
NameSpecialtyState
Nurse PractitionerFL
Physician AssistantFL
Internal Medicine, HospitalistFL
Hospitalist, Family PracticeFL
Internal MedicineFL
Internal MedicineFL
Family PracticeFL
Internal MedicineFL
Internal Medicine, HospitalistFL
Internal MedicinePA

Reviews

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Frequently asked questions

How is LEAH TEDDER identified in CMS data?
CMS-hosted NPPES data lists LEAH TEDDER with NPI 1093045569.
Is LEAH TEDDER still practicing?
LEAH TEDDER is currently listed as active in the public NPI registry.
What is LEAH TEDDER's specialty?
The listing groups LEAH TEDDER with Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for LEAH TEDDER?
LEAH TEDDER's geographic hint is Destin, Florida in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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