Individual provider Active NPI

Michelle L. Liddy, APRN, CNM

  • Advanced Practice Midwife
  • Manasquan, NJ
National Provider Identifier
1487745345
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
25ME00029900 Issued in NJ
Practice address
2671 Highway 70
Manasquan, NJ 08736-2605
Phone
(732) 528-6999
Fax
(732) 528-3397
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9483866 FL
Advanced Practice Midwife 367A00000X APRN9483866 FL
Advanced Practice Midwife 367A00000X 25ME00029900 NJ Primary

Addresses

Primary practice location

2671 Highway 70
Manasquan, NJ 08736-2605

Mailing address

330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Phone (321) 724-2229

Other practice location 1

330 E Hibiscus Blvd
Melbourne, FL 32901-3155
Phone (321) 724-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230526001134 NJ Practitioner - Certified Nurse Midwife (CNM) 3072850205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

20 Prospect Ave
Hackensack, NJ 07601-1997
Phone (551) 996-5045

Hospital & facility affiliations

  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APRN9483866FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 15, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince May 15, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

117 E County Line Rd
Lakewood, NJ 08701
Phone (732) 942-1900

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

Interoperability endpoints

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

Organizations & group practices 3

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1487745345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 E HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013155",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 HIGHWAY 70",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362605",
            "telephone_number": "732-528-6999",
            "fax_number": "732-528-3397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 E Hibiscus Blvd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013155",
            "country_code": "US",
            "telephone_number": "321-724-2229",
            "fax_number": "321-728-6681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIDDY",
        "first_name": "MICHELLE",
        "middle_name": "L.",
        "credential": "APRN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9483866",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "APRN9483866",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00029900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manasquan, NJ

Sources for this page

Verify at the official NPI Registry.