Individual provider Active NPI

Mary Cameron Leyda, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
National Provider Identifier
1619534146
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201903776NP-PP Issued in OR
Practice address
1976 Garden Ave
Eugene, OR 97403-1933
Phone
(541) 255-1411
Fax
(541) 255-1412
NPI assigned
May 21, 2019
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201903776NP-PP OR Primary

Addresses

Primary practice location

1976 Garden Ave
Eugene, OR 97403-1933

Mailing address

1976 Garden Ave
Eugene, OR 97403-1933
Phone (541) 255-1411

Other identifiers 1

IdentifierTypeStateIssuer
500763479MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1430 Willamette St
Suite 140
Eugene, OR 97401-4049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201903776NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1619534146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1976 GARDEN AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031933",
            "telephone_number": "541-255-1411",
            "fax_number": "541-255-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1976 GARDEN AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031933",
            "telephone_number": "541-255-1411",
            "fax_number": "541-255-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYDA",
        "first_name": "MARY",
        "middle_name": "CAMERON",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201903776NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500763479",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.