Individual provider Active NPI

Daniel H Libraty, M.D.

  • Infectious Disease Physician
  • Worcester, MA
National Provider Identifier
1255314100
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
215979 Issued in MA
Practice address
55 Lake Ave N
Department of Infectious Disease
Worcester, MA 01655-0002
Phone
(508) 856-4182
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 215979 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Department of Infectious Disease
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other identifiers 1

IdentifierTypeStateIssuer
0176541MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221017002184 CA Practitioner - Infectious Disease 4082791918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
University of California, San Diego School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Telemedicine Group PCGroup PAC ID 9830351824, 94 clinicians

Practice addresses (Care Compare)

135 E Compton Blvd
Compton, CA 90220-2410
Phone (424) 338-8790

2215 W Rosecrans Ave
Compton, CA 90222-3856

3400 Douglas Blvd
Suite 170
Roseville, CA 95661-4281
Phone (916) 740-3721

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215979MAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Luther King Jr Community Medical Foundation CurrentSince Nov 9, 2024 Accepting new patients
Martin Luther King Jr Community Medical Foundation Current Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Nov 9, 2024 Accepting new patients
Telehealth Specialty Medical Group Infectious Disease CurrentSince Jun 17, 2022 Accepting new patients
Tele-Medicine Services Ny, PLLC PastSince Apr 27, 2025 Accepting new patients
Access Telecare California, P.C. Infectious Disease Past Accepting new patients

Locations

2251 W Rosecrans Ave
Ste 21
Compton, CA 90222
Phone (424) 338-8790

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

3400 Douglas Blvd
Ste 170
Roseville, CA 95661
Phone (855) 446-8628

3400 Douglas Blvd
Ste 225
Roseville, CA 95661
Phone (916) 740-3721

2510 Douglas Blvd
Ste 300
Roseville, CA 95661
Phone (279) 600-4411

Interoperability endpoints

  • Direct secure messaging: telemed2u.daniellibraty@160918.advancedmd-direct.com

Organizations & group practices 6

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 3

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1255314100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF INFECTIOUS DISEASE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-856-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBRATY",
        "first_name": "DANIEL",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "215979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0176541",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.