Individual provider Active NPI

James F Libecco, MD

  • Dermatology Physician
  • Fairlawn, OH
National Provider Identifier
1215991393
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35085787 Issued in OH
Practice address
3624 W Market St
Fairlawn, OH 44333-4510
Phone
(330) 665-0555
Fax
(330) 665-0556
NPI assigned
Apr 14, 2006
Last updated
Nov 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35085787 OH Primary

Addresses

Primary practice location

3624 W Market St
Fairlawn, OH 44333-4510

Mailing address

3624 W Market St Ste 101
Fairlawn, OH 44333-4510
Phone (330) 665-0555

Other practice location 1

5915 Landerbrook Dr Ste 120
Mayfield Hts, OH 44124-4034
Phone (216) 382-3806

Other practice location 2

1560 Corporate Woods Pkwy
Uniontown, OH 44685-8730
Phone (330) 665-0555

Other identifiers 1

IdentifierTypeStateIssuer
2583619MedicaidOH

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address jl@alliedderm.emadirect.md Allied Dermatology and Skin Surgery, LLC
Direct Messaging Address jl@alliedderm.emadirect.md Allied Dermatology and Skin Surgery, LLC
Direct Messaging Address jl@alliedderm.emadirect.md Allied Dermatology and Skin Surgery, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000291 OH Practitioner - Dermatology 2769426139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Northeastern Ohio University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Dermatology and Skin Surgery, LLCGroup PAC ID 1456679646, 11 clinicians

Practice addresses (Care Compare)

5915 Landerbrook Dr
Suite 120
Mayfield Heights, OH 44124-4034
Phone (216) 382-3806

Merit-based Incentive Payment System (MIPS)

Final score
86.6 of 100Reported as group
Quality
84.98
Promoting interoperability
100
Improvement activities
40
Cost
70.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision92
Removal of skin lesions1367
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy501

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35085787OHMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Dermatology and Skin Surgery, LLC Dermatology CurrentSince Mar 7, 2015 Accepting new patients

Locations

3085 W Market St
Ste 102
Fairlawn, OH 44333
Phone (330) 379-9070

3624 W Market St
Fairlawn, OH 44333
Phone (330) 665-0555

3624 W Market St
Ste 101
Fairlawn, OH 44333
Phone (330) 665-0555

1560 Corporate Woods Pkwy
Green, OH 44685
Phone 330208272011201

5915 Landerbrook Dr
Ste 120
Mayfield Hts, OH 44124
Phone (216) 382-3806

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1215991393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 W MARKET ST STE 101",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334510",
            "telephone_number": "330-665-0555",
            "fax_number": "330-665-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 W MARKET ST",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334510",
            "telephone_number": "330-665-0555",
            "fax_number": "330-665-0556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5915 Landerbrook Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Mayfield Hts",
            "state": "OH",
            "postal_code": "441244034",
            "country_code": "US",
            "telephone_number": "216-382-3806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1560 Corporate Woods Pkwy",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "OH",
            "postal_code": "446858730",
            "country_code": "US",
            "telephone_number": "330-665-0555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBECCO",
        "first_name": "JAMES",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35085787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2583619",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jl@alliedderm.emadirect.md",
            "affiliation": "Y",
            "affiliationName": "Allied Dermatology and Skin Surgery, LLC",
            "address_1": "5915 Landerbrook Dr Ste 120",
            "city": "Mayfield Hts",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441244034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jl@alliedderm.emadirect.md",
            "affiliation": "Y",
            "affiliationName": "Allied Dermatology and Skin Surgery, LLC",
            "address_1": "3624 W Market St Ste 101",
            "city": "Fairlawn",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443334510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jl@alliedderm.emadirect.md",
            "affiliation": "Y",
            "affiliationName": "Allied Dermatology and Skin Surgery, LLC",
            "address_1": "1560 Corporate Woods Pkwy",
            "city": "Uniontown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446858730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.