Individual provider Active NPI

William Michael Leake, RN

  • Certified Registered Nurse Anesthetist
  • Washington, DC
National Provider Identifier
1386216976
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA1045097 Issued in DC
Practice address
2617 39TH St NW Apt 1
Washington, DC 20007-1219
Phone
(208) 520-3696
NPI assigned
Jul 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1045097 DC
Certified Registered Nurse Anesthetist 367500000X RNA1045097 DC Primary

Addresses

Primary practice location

2617 39TH St NW Apt 1
Washington, DC 20007-1219

Mailing address

2617 39TH St NW Apt 1
Washington, DC 20007-1219
Phone (208) 520-3696

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL None

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220726002363 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668854464 Reassigns benefits to 3 organizations
I20240313000943 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668854464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Old Dominion Anesthesia LLCGroup PAC ID 8820462765, 57 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

1800 N Beauregard St
Suite 200
Alexandria, VA 22311-1725
Phone (703) 823-3750

3007 Tilden St NW
Suite 5N
Washington, DC 20008-3030

4660 Kenmore Ave
Suite 810
Alexandria, VA 22304-1300
Phone (703) 823-0333

Hospital & facility affiliations

  • Medstar Washington Hospital Center Hospital, Washington, DC, CCN 090011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN1045097DCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jul 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Old Dominion Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 12, 2024 Accepting new patients
Medstar Medical Group II LLC CurrentSince Dec 1, 2024 Accepting new patients
Medstar Medical Group Anesthesiology LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

1800 N Beauregard St
Ste 200
Alexandria, VA 22311
Phone (703) 823-3750

3914 Centreville Rd
Ste 350
Chantilly, VA 20151
Phone (703) 263-3393

1139 E High St
Ste 105
Charlottesvle, VA 22902
Phone (434) 817-8484

Organizations & group practices 5

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 1

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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1386216976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 39TH ST NW APT 1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200071219",
            "telephone_number": "208-520-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 39TH ST NW APT 1",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200071219",
            "telephone_number": "208-520-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAKE",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1045097",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DC",
            "license": "RNA1045097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "None",
            "affiliation": "N",
            "address_1": "2617 39th St NW Apt 1",
            "city": "Washington",
            "state": "DC",
            "country_code": "US",
            "postal_code": "200071219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.