Individual provider Active NPI

Mary Beth Laliberte, PA-C

  • Physician Assistant
  • Wilbraham, MA
National Provider Identifier
1346315140
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
349 Issued in MA
Practice address
2040 Boston Rd Ste 5
Wilbraham, MA 01095
Phone
(413) 599-3800
Fax
(413) 279-1900
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 349 MA Primary

Addresses

Primary practice location

2040 Boston Rd Ste 5
Wilbraham, MA 01095

Mailing address

5 Shrewsbury St Ste D
Holden, MA 01520-1960
Phone (508) 829-3810

Other practice location 1

5 Shrewsbury St Ste D
Holden, MA 01520-1960
Phone (508) 829-3800

Other names 1

  • Mary Beth Reidy Former name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070102000390 MA Practitioner - Physician Assistant 8123028891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Specialists PCGroup PAC ID 7315198488, 10 clinicians

Practice addresses (Care Compare)

2040 Boston Rd
Suite 5
Wilbraham, MA 01095-1380
Phone (413) 599-3800

688 Bliss Rd
Longmeadow, MA 01106-1534
Phone (417) 567-0011

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
349MAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Specialists PC CurrentSince Apr 21, 2013 Accepting new patients
Urgent Care Specialists PC CurrentSince Apr 21, 2013 Accepting new patients
Baystate Medical Practices, Inc Past Accepting new patients

Locations

5 Shrewsbury St
Ste D
Holden, MA 01520
Phone (508) 829-3800

2040 Boston Rd
Ste 5
Wilbraham, MA 01095
Phone (413) 599-3800

2040 Boston Rd
Ste 16
Wilbraham, MA 01095
Phone (413) 599-3800

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1346315140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SHREWSBURY ST STE D",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015201960",
            "telephone_number": "508-829-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 BOSTON RD STE 5",
            "city": "WILBRAHAM",
            "state": "MA",
            "postal_code": "01095",
            "telephone_number": "413-599-3800",
            "fax_number": "413-279-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Shrewsbury St Ste D",
            "address_purpose": "LOCATION",
            "city": "Holden",
            "state": "MA",
            "postal_code": "015201960",
            "country_code": "US",
            "telephone_number": "508-829-3800",
            "fax_number": "508-829-3802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LALIBERTE",
        "first_name": "MARY BETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY BETH",
            "last_name": "REIDY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilbraham, MA

Sources for this page

Verify at the official NPI Registry.