Individual provider Active NPI

Courtney O'Connor Leiby

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1154836187
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
120958 Issued in PA
Practice address
736 Pine St Unit C
Philadelphia, PA 19106-4005
Phone
(267) 322-7705
Fax
(267) 322-7705
NPI assigned
Dec 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 120958 PA Primary

Addresses

Primary practice location

736 Pine St Unit C
Philadelphia, PA 19106-4005

Mailing address

734 N 19TH St
Philadelphia, PA 19130-2077

Other practice location 1

800 Spruce St
Philadelphia, PA 19107-6130
Phone (610) 220-9190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180110000459 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749549129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthomed Staffing LLCGroup PAC ID 9638429178, 373 clinicians
Society Hill Anesthesia Consultants PCGroup PAC ID 5991617292, 210 clinicians

Practice addresses (Care Compare)

491 John Young Way
Suite 100
Exton, PA 19341-2567
Phone (484) 872-8408

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 829-5664

840 Walnut St
Philadelphia, PA 19107-5109
Phone (267) 322-7700

Hospital & facility affiliations

  • Wills Eye Hospital Hospital, Philadelphia, PA, CCN 390331
  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
120958PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomed Staffing LLC CurrentSince Mar 1, 2025 Accepting new patients
Society Hill Anesthesia Consultants, PC CurrentSince Jan 2, 2018 Accepting new patients
Society Hill Anesthesia Consultants of New Jersey, PC Past Accepting new patients

Locations

491 John Young Way
Ste 100
Exton, PA 19341
Phone (443) 907-6068

301 S 8th St
Ste 2L
Philadelphia, PA 19106
Phone (215) 829-7260

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1154836187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 N 19TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 PINE ST UNIT C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064005",
            "telephone_number": "267-322-7705",
            "fax_number": "267-322-7705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191076130",
            "country_code": "US",
            "telephone_number": "610-220-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIBY",
        "first_name": "COURTNEY",
        "middle_name": "O'CONNOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-13",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "120958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.