Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jeffrey Leibman

Individual provider Physician Assistant · NPI 1457079592

Jeffrey Leibman is a Physician Assistant in Twin Falls, Idaho. Qualified in 2024, 2 years ago. Practices with St Lukes Clinic LLC, a 310-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

625 Pole Line Rd W Ste 2A
Twin Falls, ID 83301-4270
Phone: (208) 814-8600
Fax: (208) 814-8942
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1961270 (ID)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1457079592
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 15, 2022
Last updated in NPPESDecember 5, 2024
Certification dateDecember 5, 2024
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice St Lukes Clinic Llc — 310 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Twin Falls