Liam Doherty

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT020935 Issued in OH

Practice address

1 Eagle Valley CT # 240
Broadview Heights, OH 44147-2982

Phone

(216) 957-7678

NPI assigned

Jul 30, 2024

Sex

Male

Sole proprietor

No

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 OH

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• The Metrohealth System

  • Multi-Specialty Clinic/Center
  • Cleveland, OH
  • NPI 1053353896
  Medicare reassignment Care Compare group NPD
• The Metrohealth System

  • Pharmacy
  • Cleveland, OH
  • NPI 1992529911
  NPD

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1184453029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14415 GLENCLIFFE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441111319",
            "telephone_number": "216-334-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EAGLE VALLEY CT # 240",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472982",
            "telephone_number": "216-957-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "LIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT020935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Decaro
• Jina Demeo, PT
• Denice Destro
• Annette Dinallo
• Traci Lynette Dionisos, MS/CCC-SLP
• Dr. Julie Koutsoulias, Inc.
• Dr. Zenon Farian
• Eligius Behavior LLC
• Mohamed Babiker Eltayieb Eltayar
• Kylie Enders, MOTR/L

• Physical Therapist in Broadview Heights, OH
• Providers in Broadview Heights, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.