Individual provider Active NPI

Marc S Libman, M.D.

  • Forensic Psychiatry Physician
  • Rochester, NY
National Provider Identifier
1407802077
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
267812 Issued in NY
Practice address
3300 Dewey Ave
Rochester, NY 14616-3741
Phone
(585) 733-7000
NPI assigned
May 25, 2006
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X 267812 NY Primary

Addresses

Primary practice location

3300 Dewey Ave
Rochester, NY 14616-3741

Mailing address

3300 Dewey Ave
Rochester, NY 14616-3741
Phone (585) 733-7000

Other practice location 1

221 Longwood Ave
4th Floor
Boston, MA 02115-5804
Phone (617) 732-6753

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230602001639 NY Practitioner - Psychiatry 0941583116

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1407802077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 DEWEY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163741",
            "telephone_number": "585-733-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 DEWEY AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163741",
            "telephone_number": "585-733-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Longwood Ave",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155804",
            "country_code": "US",
            "telephone_number": "617-732-6753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBMAN",
        "first_name": "MARC",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NY",
            "license": "267812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.