NPIMap

Individual provider Active NPI

Marina Dewi Liem, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1265412753
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD042422E Issued in PA
Practice address
3998 Red Lion Rd
Philadelphia, PA 19114-1436
Phone
(215) 612-4021
NPI assigned
Jan 19, 2006
Last updated
Oct 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD042422E PA Primary

Addresses

Primary practice location

3998 Red Lion Rd
Philadelphia, PA 19114-1436

Mailing address

101 Greenwood Ave Ste 150
Tristate Imaging
Jenkintown, PA 19046
Phone (215) 244-3070

Other identifiers 2

IdentifierTypeStateIssuer
001815520MedicaidPA
0120634MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20061201000088 NJ Practitioner - Diagnostic Radiology 7113813718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Service Fund of Deborah Heart and Lung CenterGroup PAC ID 4284537499, 118 clinicians

Practice addresses (Care Compare)

200 Trenton Rd
Browns Mills, NJ 08015-1705
Phone (609) 893-6611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.33 of 100Reported as group
Quality
96.63
Promoting interoperability
99
Improvement activities
40
Cost
81.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042422EPAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Service Fund of Deborah Heart & Lung Center CurrentSince Oct 5, 2015 Accepting new patients
Deborah Heart and Lung Center Current Accepting new patients
Professional Service Fund of Deborah- Anesthesia Current Accepting new patients
Lebanon Imaging Associates, PC Diagnostic Radiology Past Accepting new patients
BTD Radiology at Salem PA Past Accepting new patients
Bucks County Radiology Associates, PC Diagnostic Radiology Past Accepting new patients
Diagnostic Imaging Inc Diagnostic Radiology Past Accepting new patients
Trinity Imaging Associates, P.C. Diagnostic Radiology Past Accepting new patients
Insight Health Corp Past Accepting new patients
SMH Radiology Associates PA Diagnostic Radiology Past Accepting new patients
MRI Physician Associates, PC Diagnostic Radiology Past Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology Past Accepting new patients
Delaware Open MRI Radiology Associates LLC Diagnostic Radiology Past Accepting new patients
Wilkes Barre Imaging, LLC Diagnostic Radiology PastSince Oct 1, 2009 Accepting new patients
Imaging Professionals of Pennsylvania PC Diagnostic Radiology Past Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
Barden Thorwarth Daughtridge LTD Diagnostic Radiology Past Accepting new patients
Northeast Imaging Associates of Philadelphia, P.C. Diagnostic Radiology Past Accepting new patients

Locations

200 Trenton Rd
Browns Mills, NJ 08015
Phone (609) 893-1200

Interoperability endpoints

  • Direct secure messaging: medrecs@deborah.medalliesdirect.net

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 6

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1265412753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREENWOOD AVE STE 150",
            "address_2": "TRISTATE IMAGING",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "19046",
            "telephone_number": "215-244-3070",
            "fax_number": "215-638-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141436",
            "telephone_number": "215-612-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEM",
        "first_name": "MARINA",
        "middle_name": "DEWI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD042422E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001815520",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120634",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.