NPIMap

Individual provider Active NPI

Jennifer Leibold, CRNA

  • Certified Registered Nurse Anesthetist
  • West Reading, PA
National Provider Identifier
1558810275
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN587452 Issued in PA
Practice address
420 S 5TH Ave
West Reading, PA 19611-2143
Phone
(484) 628-8269
NPI assigned
Sep 22, 2016
Last updated
Sep 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 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 RN587452 PA Primary

Addresses

Primary practice location

420 S 5TH Ave
West Reading, PA 19611-2143

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0799

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170110001689 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567743321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Health Medical GroupGroup PAC ID 7618889213, 578 clinicians

Practice addresses (Care Compare)

420 S 5TH Ave
Certified Registered Nurse Anesthetist Towe
West Reading, PA 19611-1473
Phone (484) 628-8269

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.31 of 100Reported as group
Quality
55.01
Promoting interoperability
99
Improvement activities
40
Cost
76.86

Merit-based Incentive Payment System (MIPS)

Final score
84.71 of 100Reported as group
Quality
73.34
Promoting interoperability
97
Improvement activities
40
Cost
78.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN587452PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Medical Group CurrentSince Oct 25, 2021 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Jan 17, 2018 Accepting new patients
St. Joseph Medical Group Nurse Anesthetist, Certified Registered CurrentSince Oct 25, 2021 Accepting new patients
Tower Health Medical Group CurrentSince Jan 17, 2018 Accepting new patients

Locations

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

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 6

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": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1558810275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0799",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOLD",
        "first_name": "JENNIFER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN587452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.