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

Mr. Leonard Staller, PA

Individual provider Urology Physician · NPI 1720015183

Mr. Leonard Staller, PA is a Physician Assistant in Clifton, New Jersey. Qualified in 1992, 34 years ago. Practices with Summit Medical Group PA, a 1,205-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
34
Licensed in
NJ
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1033 Clifton Ave
Clifton, NJ 07013-3517
Phone: (973) 473-5700
Fax: (973) 473-3367
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 72 W Jim Leeds Rd, Absecon, NJ 08205-9406 — (609) 652-6876

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 25MP00001000 (NJ)

Record details

NPI number1720015183
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 28, 2006
Last updated in NPPESMarch 10, 2022
Certification dateMarch 10, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Summit Medical Group Pa — 1205 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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