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

MS. Lisa Leedham, PA-C

Individual provider Physician Assistant · NPI 1881143022

MS. Lisa Leedham, PA-C is a Physician Assistant in Cloquet, Minnesota. Qualified in 2016, 10 years ago. Practices with Polinsky Medical Rehabilitation Center, a 380-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan and Minnesota.

Years since qualifying
10
Licensed in
MI, MN
In the registry since
2016
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone: (218) 879-4641
Fax: (218) 879-9167
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 901 Lakeshore Dr, Ishpeming, MI 49849-1367 — (906) 485-7777
  • 400 E 3rd St, Duluth, MN 55805-1951 — (218) 786-8364

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12573 (MN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5601007983 (MI)

Record details

NPI number1881143022
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 29, 2016
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Polinsky Medical Rehabilitation Center — 380 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Cloquet