Individual provider Active NPI

Storm Liebling, M.D.

  • Emergency Medicine Physician
  • New Haven, CT
National Provider Identifier
1326466921
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
29034901 Issued in NY
Practice address
100 York St Ste 1F
New Haven, CT 06511-5664
Phone
(203) 737-7440
NPI assigned
Apr 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 59171 CT
Emergency Medicine Physician 207P00000X 29034901 NY Primary

Addresses

Primary practice location

100 York St Ste 1F
New Haven, CT 06511-5664

Mailing address

100 York Street
Suit 1F
New Haven, CT 06511

Other practice location 1

1400 Pelham Pkwy S
Jacobi Medical Center
Bronx, NY 10461-1138
Phone (631) 219-3777

Other practice location 2

100 York St Ste 1F
New Haven, CT 06511-5664
Phone (203) 737-7440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200608001298 NY Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 7911269527 Reassigns benefits to 1 organization
I20240801003960 NY Practitioner - Pediatric Medicine 7911269527 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29034901NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Pediatrics CurrentSince Sep 1, 2024 Accepting new patients
Weill Medical College of Cornell Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jun 1, 2020 Accepting new patients
Weill Medical College of Cornell Past Accepting new patients

Locations

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: sliebling368298@direct.ynhh.org
  • Direct secure messaging: sml9026@direct.nyp.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1326466921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 YORK STREET",
            "address_2": "SUIT 1F",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 YORK ST STE 1F",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115664",
            "telephone_number": "203-737-7440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pelham Pkwy S",
            "address_2": "Jacobi Medical Center",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611138",
            "country_code": "US",
            "telephone_number": "631-219-3777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 York St Ste 1F",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065115664",
            "country_code": "US",
            "telephone_number": "203-737-7440",
            "fax_number": "203-737-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBLING",
        "first_name": "STORM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-01",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "59171",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "29034901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.