Libbit Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LIBBIT SURGICAL CENTER, LLC

Practice address

16260 Ventura Blvd
Suite 309a
Encino, CA 91436

Phone

(818) 788-4341

Fax

(818) 906-7626

NPI assigned

Feb 13, 2009

Last updated

Oct 31, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Diana Kuperman

Title

Ceo

Phone

(818) 788-4341

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1518106582. Details of each certification follow.

• CCN 05C0001913 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001913

Legal name

LIBBIT SURGICAL CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 19, 2010

Last certification

Dec 17, 2015

Ownership / control type

Proprietary

Facility address

16260 Ventura Boulevard, Suite 309
Encino, CA 91436

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1518106582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD",
            "address_2": "SUITE 309A",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-788-4341",
            "fax_number": "818-906-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16260 VENTURA BLVD",
            "address_2": "SUITE 309A",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-788-4341",
            "fax_number": "818-906-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBBIT SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "KUPERMAN",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-788-4341",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Lewton
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• Hongyan Li, O.M.D, M.D(CN)
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• Liauna Tolmasoff
• Liberty Pacific Medical Imaging Encino, LLC (Liberty Pacific MRI of Encino)
• Liberty Pacific Medical Imaging, LLC
• Philip M. Lichtenfeld, M.D.
• Jacqueline W Lichtenstein, MD
• Jena K Liddy, MD

• Ambulatory Surgical Clinic/Center in Encino, CA
• Providers in Encino, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.