Individual provider Active NPI

Liza Capodilupo, CNM

  • Advanced Practice Midwife
  • Beverly, MA
National Provider Identifier
1336531557
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN2311383 Issued in MA
Practice address
85 Herrick St
Beverly, MA 01915-1790
Phone
(978) 927-7880
NPI assigned
Feb 25, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209012418 IL
Advanced Practice Midwife 367A00000X RN2311383 MA Primary

Addresses

Primary practice location

85 Herrick St
Beverly, MA 01915-1790

Mailing address

Lahey Clinic Inc., Provider Enrollment Department
41 Mall Road
Burlington, MA 01805
Phone (781) 744-8085

Other practice location 1

1454 Baltimore Annapolis Blvd
Arnold, MD 21012-2455
Phone (410) 626-8982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180126000591 MA Practitioner - Certified Nurse Midwife (CNM) 0345509030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209012418ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Healthquarters, Inc PastSince Mar 1, 2020 Accepting new patients

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": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336531557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC INC., PROVIDER ENROLLMENT DEPARTMENT",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01805",
            "telephone_number": "781-744-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HERRICK ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151790",
            "telephone_number": "978-927-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1454 Baltimore Annapolis Blvd",
            "address_purpose": "LOCATION",
            "city": "Arnold",
            "state": "MD",
            "postal_code": "210122455",
            "country_code": "US",
            "telephone_number": "410-626-8982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAPODILUPO",
        "first_name": "LIZA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209012418",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2311383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.