Nathan Liss, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MT222609 Issued in PA

Practice address

3401 N Broad St
Philadelphia, PA 19140-5189

Phone

(267) 993-5830

NPI assigned

Jun 14, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1073181368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "267-993-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405189",
            "telephone_number": "267-993-5830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191404106",
            "country_code": "US",
            "telephone_number": "267-993-5830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISS",
        "first_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT222609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Segal Lisman, PA-C
• Rebecca S Lisowski, CRNP
• Benjamin Liss, M.D.
• Ira Liss, DMD
• Nadia A Liss, DMD
• John Listerud, M.D.
• Mary Katherine Liszka, DPT
• Joan Ava Lit, MD
• Jeffrey Litchauer, PTA
• Lev Litichevskiy, MD, PHD

• Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.