Individual provider Active NPI

Mayri Sagady Leslie, CNM

  • Advanced Practice Midwife
  • New Haven, CT
National Provider Identifier
1104071265
Registry record updated Mar 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
336 Issued in CT
Practice address
100 Church St S
New Haven, CT 06519-1703
Phone
(619) 743-4989
Fax
(203) 737-2597
NPI assigned
Nov 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2010

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001206629 VA
Registered Nurse 163W00000X 504434 CA
Advanced Practice Midwife 367A00000X 0024167388 VA
Advanced Practice Midwife 367A00000X RN1011287 DC
Advanced Practice Midwife 367A00000X 1274 CA
Advanced Practice Midwife 367A00000X 336 CT Primary
Advanced Practice Midwife 367A00000X AC00567 MD
Registered Nurse 163W00000X 89442 CT

Addresses

Primary practice location

100 Church St S
New Haven, CT 06519-1703

Mailing address

100 Church St S
New Haven, CT 06519-1703
Phone (619) 743-4989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
336CTMDBehavioral Analyst
504434CAMDRegistered Nurse
89442CTMDRegistered Nurse
0001206629VAMDRegistered Nurse
1274CAMDSpeech-Language Assistant
RN1011287DCMDAdvanced Practice Midwife
AC00567MDMDAdvanced Practice Midwife
0024167388VAMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267920000000",
    "number": "1104071265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHURCH ST S",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191703",
            "telephone_number": "619-743-4989",
            "fax_number": "203-737-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHURCH ST S",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191703",
            "telephone_number": "619-743-4989",
            "fax_number": "203-737-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "MAYRI",
        "middle_name": "SAGADY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2010-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001206629",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "504434",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024167388",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "DC",
            "license": "RN1011287",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1274",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "336",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MD",
            "license": "AC00567",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "89442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.