Individual provider Active NPI

Boaz Y Leung, CRNA

  • Certified Registered Nurse Anesthetist
  • Martinsburg, WV
National Provider Identifier
1770520967
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AC000362 Issued in MD
Practice address
94 Old Mill Rd
Martinsburg, WV 25401-9284
Phone
(304) 264-8933
Fax
(304) 264-8846
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AC000362 MD Primary
Certified Registered Nurse Anesthetist 367500000X 71474 WV

Addresses

Primary practice location

94 Old Mill Rd
Martinsburg, WV 25401-9284

Mailing address

94 Old Mill Rd
Martinsburg, WV 25401-9284
Phone (304) 264-8933

Other identifiers 2

IdentifierTypeStateIssuer
3810009996MedicaidWV
410478100MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060727000059 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092720128 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shock Trauma Associates PAGroup PAC ID 6800882317, 258 clinicians

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704

827 Linden Ave
Baltimore, MD 21201-4606
Phone (667) 214-1616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71474WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Maryland LLC CurrentSince Oct 13, 2017 Accepting new patients
Shock Trauma Associates, P.a. CurrentSince Jan 25, 2025 Accepting new patients
University of Maryland Anesthesiology Associates, P.a. CurrentSince Jul 25, 2017 Accepting new patients
Eastern Panhandle Anesthesia Associates Past Accepting new patients
Wvuh-East Services, Inc Past Accepting new patients
Greenville Health System Past Accepting new patients
City Hospital Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

611 S Charles St
Baltimore, MD 21230
Phone (410) 328-6331

250 W Pratt St
Ste 900
Baltimore, MD 21201
Phone (410) 328-6267

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

Interoperability endpoints

  • Direct secure messaging: bleung482925@direct.umm.edu

Organizations & group practices 7

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271030400000",
    "number": "1770520967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019284",
            "telephone_number": "304-264-8933",
            "fax_number": "304-264-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD MILL RD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254019284",
            "telephone_number": "304-264-8933",
            "fax_number": "304-264-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "BOAZ",
        "middle_name": "Y",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "AC000362",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "71474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810009996",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410478100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.