Mark C Leefeldt, O.A.
Physician Assistant in St Louis Park, MN. Individual provider (NPI-1).
NPI number1790764660
StatusActive
Last updated in NPPESJul 13, 2026
Details
- NPI
- 1790764660
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mark C Leefeldt
- Credential
- O.A.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 10, 2006
- Last updated
- Jul 13, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
6490 Excelsior BlvdSte E400
St Louis Park, MN 55426-4705
Phone 952-993-3230
Mailing address
6465 Wayzata BlvdSte 315
St Louis Park, MN 55426-1728
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 110 Physician Assistant providers in St Louis Park · All 3,529 providers in St Louis Park
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