Individual provider Active NPI

Elliot Martin Libling, MD

  • Otolaryngology Physician
  • Glendale, AZ
National Provider Identifier
1528096989
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
20805 Issued in AZ
Practice address
18700 N 64TH Dr
Ste 312
Glendale, AZ 85308-7114
Phone
(623) 566-4718
Fax
(623) 566-4820
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 20805 AZ Primary

Addresses

Primary practice location

18700 N 64TH Dr
Ste 312
Glendale, AZ 85308-7114

Mailing address

18700 N 64TH Dr
Ste 312
Glendale, AZ 85308-7114
Phone (623) 566-4718

Other identifiers 1

IdentifierTypeStateIssuer
122838001MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20070531000531 AZ Practitioner - Otolaryngology 0345143095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley ENT PCGroup PAC ID 8729149711, 70 clinicians

Practice addresses (Care Compare)

9097 E Desert Cove Ave
Suite 250
Scottsdale, AZ 85260-6278
Phone (480) 847-1193

9250 W Thomas Rd
Suite 350
Phoenix, AZ 85037-3385
Phone (623) 848-8890

Hospital & facility affiliations

  • Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as group
Quality
71.49
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20805AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Ear Nose and Throat PC Otolaryngology PastSince Sep 1, 2001 Accepting new patients
Valley ENT, PC Otolaryngology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: martin.libling@1028.chartlogic.direct-ci.com

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 1

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528096989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 N 64TH DR",
            "address_2": "STE 312",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087114",
            "telephone_number": "623-566-4718",
            "fax_number": "623-566-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 N 64TH DR",
            "address_2": "STE 312",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087114",
            "telephone_number": "623-566-4718",
            "fax_number": "623-566-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBLING",
        "first_name": "ELLIOT",
        "middle_name": "MARTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "20805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122838001",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.