Active NPI
Liberty Orthotics, Inc.
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
National Provider Identifier
1083654503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- LIBERTY ORTHOTICS, INC.
- Practice address
- 1201 2ND Ave
New Hyde Park, NY 11040-4925 - Phone
- (516) 326-6786
- Fax
- (516) 326-6784
- NPI assigned
- Jun 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Francis Xavier Brandt Sr.
- Title
- President/Owner
- Phone
- (516) 326-6786
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
1201 2ND Ave
New Hyde Park, NY 11040-4925
Mailing address
1201 2ND Ave
New Hyde Park, NY 11040-4925
Phone (516) 326-6786
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000023042 | Other | NY | AFFINITY PROVIDER NUMBER |
| 3125 | Other | NY | NY PRESBYTERIAN SELECT |
| 02010093 | Medicaid | NY | |
| 000412358262 | Other | NY | HEALTH PLUS |
| 04072200123 | Other | NY | FIDELIS HEALTH PLANS |
| 1211801 | Other | NY | COMMUNITY PREMIER PLUS |
| 2021095 | Other | NY | AETNA PROVIDER NUMBER |
| 4C4927 | Other | NY | HEALTH NET |
| 10532 | Other | NY | HUDSON HEALTH PLAN |
| 57P0182 | Other | NY | ABC HEALTH PLANS |
| 10093592 | Other | NY | CDPHP PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930091687 | NY | DME Supplier - Medical Supply Company | 1153442793 | Practice locations: New Hyde Park, NY |
National Provider Directory
National Provider Directory- Tax ID family
- Liberty Orthotics Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
- NPI 1497448567
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Durable Medical Equipment & Medical Supplies
- New Hyde Park, NY
- NPI 1497448567
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1083654503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 2ND AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110404925",
"telephone_number": "516-326-6786",
"fax_number": "516-326-6784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 2ND AVE",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110404925",
"telephone_number": "516-326-6786",
"fax_number": "516-326-6784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIBERTY ORTHOTICS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BRANDT",
"authorized_official_first_name": "FRANCIS",
"authorized_official_middle_name": "XAVIER",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "516-326-6786",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Sr."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AFFINITY PROVIDER NUMBER",
"identifier": "1000023042",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY PRESBYTERIAN SELECT",
"identifier": "3125",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02010093",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLUS",
"identifier": "000412358262",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS HEALTH PLANS",
"identifier": "04072200123",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY PREMIER PLUS",
"identifier": "1211801",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "2021095",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "4C4927",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUDSON HEALTH PLAN",
"identifier": "10532",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ABC HEALTH PLANS",
"identifier": "57P0182",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP PROVIDER #",
"identifier": "10093592",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.