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

John Lewis Leake

Individual provider Surgical Physician Assistant · NPI 1114600780

John Lewis Leake is a Physician Assistant in Fort Worth, Texas. Qualified in 2024, 2 years ago. Practices with Texas Health Physicians Group, a 1,356-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Texas and Utah.

Years since qualifying
2
Licensed in
TX, UT
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

800 5th Ave Ste 300
Fort Worth, TX 76104-7303
Phone: (817) 250-6575
Fax: (817) 250-0109
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3674 S Washington St, Grand Forks, ND 58201-5766 — (701) 205-3000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14199280-1206 (UT)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA19359 (TX)

Record details

NPI number1114600780
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 10, 2023
Last updated in NPPESApril 20, 2026
Certification dateApril 20, 2026
Mailing addressPo Box 5210, Grand Forks, ND 58206-5210

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 Texas Health Physicians Group — 1356 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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