Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Leandra Bibiana Bazan, PA-C, MT

Individual provider Physician Assistant · NPI 1407947286

Leandra Bibiana Bazan, PA-C, MT is a Physician Assistant in Greeley, Colorado. Qualified in 2006, 20 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Colorado and Florida.

Years since qualifying
20
Licensed in
CO, FL
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
MT — Medical Technologist
Performs laboratory testing on clinical specimens.

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Practice location Address checks out

1900 16th St
Greeley, CO 80631
Phone: (970) 350-2426
Fax: (970) 350-2478
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4801 N Federal Hwy, Fort Lauderdale, FL 33308-4618 — (954) 202-0242
  • 4801 N Federal Hwy, Fort Lauderdale, FL 33308-4618 — (954) 202-0242

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA0005128 (CO)
Physician Assistant Taxonomy 363A00000X · Licence PA9103879 (FL)
Medical Art Specialist/Technologist Taxonomy 246ZA2600X · Licence TN35171 (FL)

Record details

NPI number1407947286
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , MT
Sole proprietorNo
NPI enumeratedSeptember 27, 2006
Last updated in NPPESNovember 28, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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