Individual provider Active NPI

Judy A Diliberto, PA

  • Physician Assistant
  • Liverpool, NY
National Provider Identifier
1124109467
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009028-1 Issued in NY
Practice address
5112 W Taft Rd
Suite H
Liverpool, NY 13088-4868
Phone
(315) 452-3235
Fax
(315) 452-5726
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009028-1 NY Primary

Addresses

Primary practice location

5112 W Taft Rd
Suite H
Liverpool, NY 13088-4868

Mailing address

5112 W Taft Rd
Suite H
Liverpool, NY 13088-4868
Phone (315) 452-3235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101026000278 NY Practitioner - Physician Assistant 6800089517 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045-1206
Phone (607) 756-3500

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

720 Willow Ave
Ithaca, NY 14850-3215
Phone (607) 219-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009028-1NYMDMental Health Counselor
9028NYMDCognitive & Behavioral Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. CurrentSince Feb 1, 2022 Accepting new patients
Digestive Disease Center of Central New York, LLC Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Feb 1, 2022 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

134 Homer Ave
Cortland, NY 13045
Phone (607) 756-3500

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: jdiliberto171699@direct-guthrie.org
  • Direct secure messaging: dilibertoj@hiemail.healtheconnections.org

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1124109467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 W TAFT RD",
            "address_2": "SUITE H",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884868",
            "telephone_number": "315-452-3235",
            "fax_number": "315-452-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 W TAFT RD",
            "address_2": "SUITE H",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884868",
            "telephone_number": "315-452-3235",
            "fax_number": "315-452-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILIBERTO",
        "first_name": "JUDY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009028-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.