NPIMap

Organization Active NPI

Lifecare Medical Office, PC

  • Internal Medicine Physician
  • Arverne, NY
National Provider Identifier
1124545751
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFECARE MEDICAL OFFICE, PC
Practice address
6514 Beach Front Rd
Arverne, NY 11692-1293
Phone
(646) 382-7742
Fax
(646) 417-5002
NPI assigned
Aug 24, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Jolanta J Libura, MD, PHDNPI 1205190535
Title
Owner
Phone
(646) 382-7742

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

6514 Beach Front Rd
Arverne, NY 11692-1293

Mailing address

6514 Beach Front Rd
Arverne, NY 11692-1293
Phone (646) 382-7742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171215000512 NY Part B Supplier - Clinic/Group Practice 9436417698 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY; New York, NY; Arverne, NY

National Provider Directory

National Provider Directory

Locations

98 Richards St
Brooklyn, NY 11231
Phone (646) 382-7742

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124545751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6514 BEACH FRONT RD",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921293",
            "telephone_number": "646-382-7742",
            "fax_number": "646-417-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6514 BEACH FRONT RD",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921293",
            "telephone_number": "646-382-7742",
            "fax_number": "646-417-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE MEDICAL OFFICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LIBURA",
        "authorized_official_first_name": "JOLANTA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-382-7742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arverne, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.