Individual ProviderKeith C LeverenzAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address111 Colchester Ave, Fahc-Wp2, Burlington, VT 05401-1473(802) 847-2415PECOS EnrollmentBased on the most recent information from CMS, provider Keith C Leverenz does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1275574600Provider TypeIndividualFull NameLeverenz, Keith CCredentialM.D.GenderMaleEnumeration Date6/9/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address111 Colchester Ave, Fahc-Wp2, Burlington, VT 05401-1473Phone(802) 847-2415Fax(802) 847-5324Mailing LocationMailing Address111 Colchester Ave, Fahc-Wp2, Burlington, VT 05401-1473Phone(802) 847-2415Fax(802) 847-5324Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicense042-0007211VermontProvider IdentifiersIDDescriptionIssuerID0005247DescriptionMedicaidIssuerUnlistedVermontID01165791DescriptionMedicaidIssuerUnlistedNew York