Individual provider Active NPI

Juliane Liberus, PA-C

  • Medical Physician Assistant
  • Somerville, MA
National Provider Identifier
1033468467
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA4475 Issued in MA
Practice address
337 Somerville Ave
Somerville, MA 02143
Phone
(617) 665-3370
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA4475 MA Primary

Addresses

Primary practice location

337 Somerville Ave
Somerville, MA 02143

Mailing address

Cambridge Health Alliance
26 Central St
Somerville, MA 02143
Phone (617) 665-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121101000560 MA Practitioner - Physician Assistant 4385894153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

391 Broadway
Suite 204
Everett, MA 02149-3471
Phone (617) 389-0045

Hospital & facility affiliations

  • Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA4475MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince Jun 1, 2017 Accepting new patients
Cambridge Public Health Commission CurrentSince Aug 1, 2012 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Jun 1, 2017 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

391 Broadway
Ste 204
Everett, MA 02149
Phone (617) 387-0473

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

391 Broadway
Everett, MA 02149
Phone (617) 387-0473

26 Central St
Somerville, MA 02143
Phone (617) 591-6033

337 Somerville Ave
Somerville, MA 02143
Phone (617) 627-9040

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

Interoperability endpoints

  • Direct secure messaging: jliberus29325@direct.challiance.masshiway.net

Organizations & group practices 5

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 2

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": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447200000000",
    "number": "1033468467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAMBRIDGE HEALTH ALLIANCE",
            "address_2": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02143",
            "telephone_number": "617-665-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 SOMERVILLE AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02143",
            "telephone_number": "617-665-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERUS",
        "first_name": "JULIANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2015-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.