Ilyssa Liberto

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1 Bartol Ave Ste 100
Ridley Park, PA 19078-2214

Phone

(610) 521-9996

NPI assigned

Aug 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Orthopaedic and Sports Medicine Associates, LTDGroup PAC ID 5890681092, 218 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.4 of 100Reported as group

Quality

82.63

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

96.6 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ilyssa.liberto.1@22724.direct.athenahealth.com

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.

• Premier Orthopaedic and Sports Medicine Associates, LTD

  • Orthopaedic Surgery Physician
  • Newtown Square, PA
  • NPI 1215987243
  Medicare reassignment Care Compare group NPD
• Premier Orthopaedic and Sports Medicine Associates LTD

  • Durable Medical Equipment & Medical Supplies
  • Exton, PA
  • NPI 1497485080
  NPD
• Orthopedic Sports & Arthritis Surgery

  • Orthopaedic Surgery Physician
  • Paoli, PA
  • NPI 1316917594
  NPD (past)

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1437933298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34990",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049150627",
            "telephone_number": "610-359-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARTOL AVE STE 100",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782214",
            "telephone_number": "610-521-9996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Harris Dr",
            "address_purpose": "LOCATION",
            "city": "Sewell",
            "state": "NJ",
            "postal_code": "080809458",
            "country_code": "US",
            "telephone_number": "856-723-9556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Abington",
            "state": "PA",
            "postal_code": "190013720",
            "country_code": "US",
            "telephone_number": "215-481-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBERTO",
        "first_name": "ILYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melvyn J Lapes, M.D.
• Wing Yan Lau, RDN
• Cynthia Elizabeth Lee, M.D.
• Leedom Fire Company No 1
• Richard E Leyman, PA-C
• Lily & Rose Home Care
• Milly H Long, MD
• Amy Lee Lundholm, D.O.
• Jeffrey Malumed, M.D.
• Jessica Manzi, LCSW

• Medical Physician Assistant in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.