Jacob Liechty, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME161943 Issued in FL

Practice address

1247 Lakeland Hills Blvd
Lakeland, FL 33805-4673

Phone

(863) 688-5604

NPI assigned

Mar 20, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Ophthalmology

Education

Eastern Virginia Medical School, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Eye Physicians of Pinellas, PAGroup PAC ID 5092629071, 39 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: jliechty@laec.intellechartdirect.net

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.

• The Eye Physicians of Pinellas, PA

  • Ophthalmology Physician
  • Largo, FL
  • NPI 1114925153
  Medicare reassignment Care Compare group NPD
• Lakeland Eye Clinic PA

  • Ophthalmology Physician
  • Lakeland, FL
  • NPI 1154414159
  NPD
• The Eye Physicians of Pinellas, PA

  • Durable Medical Equipment & Medical Supplies
  • Lakeland, FL
  • NPI 1790488013
  NPD
• The Eye Physicians of Pinellas, PA

  • Ambulatory Surgical Clinic/Center
  • Largo, FL
  • NPI 1366710741
  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1467912253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 13TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054673",
            "telephone_number": "863-688-5604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1243 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054673",
            "country_code": "US",
            "telephone_number": "863-262-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4708 S Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338132165",
            "country_code": "US",
            "telephone_number": "863-644-6455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIECHTY",
        "first_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME161943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.