NPIMap

Individual provider Active NPI

Daniel Libke, M.D.

  • Emergency Medicine Physician
  • Piedmont, CA
National Provider Identifier
1154460517
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A39313 Issued in CA
Practice address
385 Moraga Ave
Piedmont, CA 94611-3927
Phone
(510) 410-1545
NPI assigned
Feb 5, 2007
Last updated
Jul 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A39313 CA Primary

Addresses

Primary practice location

385 Moraga Ave
Piedmont, CA 94611-3927

Mailing address

2100 Powell St Ste 900
Cep-Medamerica Attn. Berta Avila
Emeryville, CA 94608-1844
Phone (510) 350-2664

Other identifiers 1

IdentifierTypeStateIssuer
A39313OtherCAMEDICAL DOCTOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018000621 NV Practitioner - Emergency Medicine 7214016617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Southern Illinois University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winnemucca Emergency Physicians LLCGroup PAC ID 2860434503, 16 clinicians
Hoover Emergency Physicians LLCGroup PAC ID 0648450296, 17 clinicians

Practice addresses (Care Compare)

118 E Haskell St
Winnemucca, NV 89445-3247
Phone (954) 939-5000

901 Adams Blvd
Boulder City, NV 89005-2213
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39313CAMDDentist
A39313CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 29, 2018 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 29, 2018 Accepting new patients
Winnemucca Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2025 Accepting new patients
Emcare Physician Providers Inc Emergency Medicine Past Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

13737 Noel Rd
Ste 1600
Dallas, TX 75240
Phone (214) 712-2489

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1154460517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 900",
            "address_2": "CEP-MEDAMERICA ATTN. BERTA AVILA",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081844",
            "telephone_number": "510-350-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MORAGA AVE",
            "city": "PIEDMONT",
            "state": "CA",
            "postal_code": "946113927",
            "telephone_number": "510-410-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBKE",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A39313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DOCTOR",
            "identifier": "A39313",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, CA

Sources for this page

Verify at the official NPI Registry.