Individual provider Active NPI

Leah R. Bostic, CRNA

  • Certified Registered Nurse Anesthetist
  • Peoria, IL
National Provider Identifier
1528190170
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209-004635 Issued in IL
Practice address
8600 State Route 91 Ste 250
Peoria, IL 61615-7831
Phone
(309) 692-5393
Fax
(309) 692-2538
NPI assigned
Mar 9, 2007
Last updated
Jun 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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 209-004635 IL Primary

Addresses

Primary practice location

8600 State Route 91 Ste 250
Peoria, IL 61615-7831

Mailing address

8600 State Route 91 Ste 250
Peoria, IL 61615-7831
Phone (309) 692-5393

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080512000146 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0749369056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians

Practice addresses (Care Compare)

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-3311

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-004635ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, SC CurrentSince Dec 6, 2020 Accepting new patients
Associated Anesthesiologists, S.C. CurrentSince Jun 20, 2016 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Dec 1, 2022 Accepting new patients
Anesthesiology Consultants LTD Nurse Anesthetist, Certified Registered Past Accepting new patients
Guardian Headache & Pain Management Institute LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2200 E Washington St
Bloomington, IL 61701
Phone (309) 661-5111

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

8600 State Route 91
Ste 250
Peoria, IL 61615
Phone (309) 692-5393

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1528190170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 STATE ROUTE 91 STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157831",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 STATE ROUTE 91 STE 250",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157831",
            "telephone_number": "309-692-5393",
            "fax_number": "309-692-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTIC",
        "first_name": "LEAH",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-004635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.