Individual provider Active NPI

Gary R Liberati, DMD

  • General Practice Dentistry
  • Pittsburgh, PA
National Provider Identifier
1508948290
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS021430L Issued in PA
Practice address
509 Long Rd
Pittsburgh, PA 15235-4330
Phone
(412) 243-7117
Fax
(412) 243-7173
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS021430L PA Primary

Addresses

Primary practice location

509 Long Rd
Pittsburgh, PA 15235-4330

Mailing address

509 Long Rd
Pittsburgh, PA 15235-4330
Phone (412) 243-7117

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150116001431 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2860630407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS021430LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Liberati, DMD and Associates, PC PastSince Sep 1, 1979 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1508948290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 LONG RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152354330",
            "telephone_number": "412-243-7117",
            "fax_number": "412-243-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 LONG RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152354330",
            "telephone_number": "412-243-7117",
            "fax_number": "412-243-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERATI",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS021430L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.