Individual provider Active NPI

Anna S Liberatore, M.D.

  • Emergency Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1437479698
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME114737 Issued in FL
Practice address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone
(386) 425-2285
Fax
(386) 425-7522
NPI assigned
Jun 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TRN15227 FL
Emergency Medicine Physician 207P00000X ME114737 FL Primary

Addresses

Primary practice location

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Mailing address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130826000205 FL Practitioner - Emergency Medicine 7618112830 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Vermont College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Professionals PAGroup PAC ID 0446244362, 20 clinicians

Practice addresses (Care Compare)

401 Palmetto St
New Smyrna Beach, FL 32168-7322
Phone (386) 917-5030

Hospital & facility affiliations

  • Adventhealth New Smyrna Beach Hospital, New Smyrna Beach, FL, CCN 100014
  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114737FLMDEmergency Medicine Physician
TRN15227FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc Emergency Medicine CurrentSince Jul 22, 2013 Accepting new patients
Emergency Medicine Professionals PA Emergency Medicine CurrentSince Dec 15, 2016 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

401 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 424-5000

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1437479698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-2285",
            "fax_number": "386-425-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERATORE",
        "first_name": "ANNA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN15227",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME114737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.