Individual provider Active NPI

Leonid Levertov, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbus, OH
National Provider Identifier
1720552714
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019894 Issued in OH
Practice address
410 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-5000
NPI assigned
Jan 14, 2019
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 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 APRN.CRNA.019894 OH Primary

Addresses

Primary practice location

410 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

2097 Olde Sawmill Blvd
Dublin, OH 43016-9091
Phone (614) 596-9464

Other practice location 1

3400 Olentangy River Rd
Columbus, OH 43202-1523
Phone (614) 754-5500

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address llevertov33526@lickingmemorial.medicity.net Licking Memorial Professional Corporation
Direct Messaging Address ohio.gastro@directaddress.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190529003021 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082957311 Reassigns benefits to 17 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams Ohio PLLCGroup PAC ID 2769743335, 14 clinicians
Ohio Gastroenterology Group, Inc.Group PAC ID 0143211284, 118 clinicians
Osu Observation Medicine, LLCGroup PAC ID 3375692270, 423 clinicians
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians

Practice addresses (Care Compare)

1320 W Main St
Licking Memorial Anesthesiology
Newark, OH 43055-1822
Phone (220) 564-4226

3056 Columbus Lancaster Rd NW
Lancaster, OH 43130-8126
Phone (740) 785-9350

3400 Olentangy River Rd
Columbus, OH 43202-1576
Phone (614) 754-5500

410 W 10TH Ave
Columbus, OH 43210-1240
Phone (614) 293-8487

5040 Forest Dr
Suite 100
New Albany, OH 43054-9187
Phone (614) 775-1616

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.32 of 100Reported as apm
Quality
71.78
Promoting interoperability
98.93
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince May 9, 2023 Accepting new patients
Ohio Gastroenterology Group, Inc. CurrentSince Sep 2, 2025 Accepting new patients
Ohiohealth Corporation CurrentSince Apr 1, 2020 Accepting new patients
Licking Memorial Health Professionals Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jun 7, 2023 Accepting new patients
Licking Memorial Professional Corporation CurrentSince Jun 7, 2023 Accepting new patients
Osu Observation Medicine, LLC CurrentSince Aug 1, 2024 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Jul 1, 2019 Accepting new patients
Anesthesia Group Practice, Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 13, 2025 Accepting new patients
Lima Memorial Professional Corporation CurrentSince Aug 15, 2022 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Marion Area Physicians LLC CurrentSince Jun 3, 2019 Accepting new patients
Premier Anesthesia of Ohio LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2023 Accepting new patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 20, 2023 Accepting new patients
West Broad Anesthesia, Inc. Nurse Anesthetist, Certified Registered CurrentSince Dec 5, 2024 Accepting new patients
Ogi Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 5, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations (25 of 37)

3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209

2925 Vernon Pl
Ste 101
Cincinnati, OH 45219
Phone (513) 872-4541

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

111 S Grant Ave
Fl 3
Columbus, OH 43215
Phone (614) 566-9871

275 Taylor Station Rd
Columbus, OH 43213
Phone (614) 566-9983

3400 Olentangy River Rd
Columbus, OH 43202
Phone (614) 754-5545

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

85 McNaughten Rd
Ste 320
Columbus, OH 43213
Phone 61475455005545

Dept L3652
Columbus, OH 43260

L3977
Columbus, OH 43260

L3982
Columbus, OH 43260

4200 Indian Ripple Rd
Dayton, OH 45440
Phone (937) 320-5050

75 Sylvania Dr
Dayton, OH 45440
Phone (937) 320-5050

6670 Perimeter Dr
Ste 200
Dublin, OH 43016

9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050

701 Tech Center Dr
Ste 100
Gahanna, OH 43230
Phone (440) 724-4498

722 Buckles Ct N
Ste 100
Gahanna, OH 43230
Phone (614) 754-5455

5300 N Meadows Dr
Grove City, OH 43123
Phone (614) 234-4242

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 5

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": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1720552714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2097 OLDE SAWMILL BLVD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430169091",
            "telephone_number": "614-596-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Olentangy River Rd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432021523",
            "country_code": "US",
            "telephone_number": "614-754-5500",
            "fax_number": "614-754-5501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVERTOV",
        "first_name": "LEONID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-14",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llevertov33526@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "affiliationName": "Licking Memorial Professional Corporation",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ohio.gastro@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Olentangy River Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432021523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.