Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tracie Diane Leveridge

Individual provider Advanced Practice Midwife · NPI 1053980565

Tracie Diane Leveridge is a Certified Nurse Midwife (CNM) in San Antonio, Texas. Qualified in 2021, 5 years ago. Practices with Peterson Medical Associates, a 191-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
5
Licensed in
TX
In the registry since
2021
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Practice location Address checks out

5616 Lone Star Pkwy
San Antonio, TX 78253-2200
Phone: (210) 281-5066
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Advanced Practice Midwife (primary) Taxonomy 367A00000X · Licence 1030791 (TX)

Record details

NPI number1053980565
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 19, 2021
Last updated in NPPESJune 19, 2021
Certification dateJune 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED NURSE MIDWIFE (CNM)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Peterson Medical Associates — 191 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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