Tracie Diane Leveridge

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

1030791 Issued in TX

Practice address

5616 Lone Star Pkwy
San Antonio, TX 78253-2200

Phone

(210) 281-5066

NPI assigned

Jun 19, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peterson Medical AssociatesGroup PAC ID 1355467887, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracie.leveridge.1@21041.direct.athenahealth.com
• Direct secure messaging: tracie.leveridge.1@23211.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peterson Medical Associates

  • Obstetrics & Gynecology Physician
  • Kerrville, TX
  • NPI 1770800575
  Medicare reassignment Care Compare group NPD
• Boerne OB/GYN, P.a.

  • Obstetrics & Gynecology Physician
  • Boerne, TX
  • NPI 1215267919
  NPD (past)
• Sid Peterson Memorial Hospital

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sid Peterson Memorial Hospital

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624060800000",
    "number": "1053980565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAINT ROBBY CT",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637637",
            "telephone_number": "817-269-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 LONE STAR PKWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532200",
            "telephone_number": "210-281-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERIDGE",
        "first_name": "TRACIE",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2021-06-19",
        "certification_date": "2021-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "1030791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henrique Levcovitz, MD
• Level Up Counseling
• Robert Richard Leverence, MD
• Robert Stephen Leverence, DO
• Karen Sue Leverett, LVN
• Deborah Sue Levi, LSCW
• Sarah Levic, CRNA
• Judy Ponce Levin, NP-C
• Oren Isaac Levin, M.D.
• Harriet Elise Levine, LCSW

• Advanced Practice Midwife in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Advanced Practice Midwife in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.