Maryana Liedke, DO

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

288433 Issued in NY

Practice address

1010 Route 112 Ste 300
Port Jefferson Station, NY 11776-3386

Phone

(631) 364-9119

NPI assigned

Apr 2, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maryana Furmansky Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Neurology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

True North Medical at North Suffolk, PLLCGroup PAC ID 0345618088, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Networks

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

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JIEEAD

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.

• True North Medical at North Suffolk PLLC

  • Neurology Physician
  • Port Jefferson Station, NY
  • NPI 1639804628
  Medicare reassignment Care Compare group NPD
• Todd J. Maltese, D.O., P.C.

  • Neurology Physician
  • Ronkonkoma, NY
  • NPI 1902290869
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1033224704
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1225507114
  Care Compare affiliation
• University Hospital at Stony Brook

  • Land Ambulance
  • Stony Brook, NY
  • NPI 1306620588

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Greenport, NY
  • NPI 1881690691
  Care Compare affiliation
• University Hospital at Stony Brook

  • Clinic/Center
  • Greenport, NY
  • NPI 1932466604

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  Care Compare affiliation

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1386987956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 ROUTE 112 STE 300",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763386",
            "telephone_number": "631-364-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 ROUTE 112 STE 300",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763386",
            "telephone_number": "631-364-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDKE",
        "first_name": "MARYANA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-02",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "288433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANA",
            "last_name": "FURMANSKY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan A Levanti
• Jourdan T Levy Petrone
• Li Anxiety Care
• William J Li Pera, MD
• Melissa Liebold, PA-C
• Lifeskillsandpsychotherapy Services, PC
• Jody Lin, PHARMD/MBA
• Patricia Lin
• Sophia Vivian Lin, D.C.
• Kathleen Lindahl, LCSW

• Neurology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.