MARY K LEAVERY CRNA
NPI 1063520005
Nurse Anesthetist, Certified Registered in Winston Salem, NC

Active since August 29, 2006Accepts Medicare Assignment
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103(336) 768-3212(336) 768-9019 Get Directions Write a Review

NPPES record last updated: October 28, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 28, 2020, Mar 18, 2019 (2 updates tracked since 2019).

About Mary K Leavery Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY K LEAVERY CRNA (NPI 1063520005) is an individual nurse anesthetist, certified registered in Winston Salem, North Carolina, licensed in North Carolina (45453) and active in the NPI registry since August 2006. She is affiliated with Novant Health Forsyth Medical Center, maintains a secondary practice location in Watertown, and is a graduate of State University Of New York At Buffalo School Of Medicine (1995).

NPPES Registry Identity

NPI1063520005
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameMARY K LEAVERYCredential: CRNA
Location Address145 KIMEL PARK DR STE 120Winston Salem, NC 27103
Mailing Address145 Kimel Park Dr Ste 120Winston Salem, NC 27103-6983 · (336) 768-3212 · Fax (336) 768-9019
Fax(336) 768-9019
Sole ProprietorNo
Medical School CMSState University Of New York At Buffalo School Of MedicineGraduated 1995
Enumeration DateAugust 29, 2006
Last NPPES UpdateOctober 28, 20202 updates tracked since enumeration
NPPES CertifiedOctober 28, 2020
NPI 1063520005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
Licenses Licensed in NC · 45453 Licensed in SC · 993
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedRegistered NurseTaxonomy 163W00000X · License 360053-1 (NY)
145 KIMEL PARK DR STE 120, Winston Salem, NC 27103

Secondary Practice Location 1

Location 1830 Washington StWatertown, NY 13601-4034 · Phone (315) 785-4313 · Fax (315) 779-5114

Other Identifiers 1

MedicaidAN0749SC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mary K Leavery Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628068301
PECOS Enrollment IDI20091001000652

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for other procedure on urinary system through urethra 00910
Anesthesia for a procedure on the urinary system through the urethra involves using medicine to numb sensation in the area. This is done to ensure you feel no pain or discomfort during the procedure. The medicine can be given locally, regionally, or generally, depending on the specifics of your procedure.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340014
Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County
Emergency services Birthing friendly

Novant Health Medical Park Hospital

Acute Care Hospitals · Winston-Salem, NC
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340148
Location1950 S Hawthorne RdWinston-Salem, NC 27103 · Forsyth County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Anesthesiology
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Anesthesiology
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Anesthesiology
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Anesthesiology
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103
Anesthesiology
145 KIMEL PARK DR STE 120
WINSTON SALEM, NC 27103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Leavery's NPI number?

The NPI number for Mary Leavery is 1063520005. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Where is Mary Leavery located?

Mary Leavery practices at 145 Kimel Park Dr Ste 120, Winston Salem, NC 27103. The listed phone number is (336) 768-3212.

What is Mary Leavery's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Mary Leavery enrolled in Medicare?

Yes. Mary Leavery is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Mary Leavery affiliated with any hospitals?

According to CMS data, Mary Leavery is affiliated with Novant Health Forsyth Medical Center and Novant Health Medical Park Hospital.

When was this NPI record last updated?

The NPPES record for Mary Leavery was last updated on October 28, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.