NPIMap

Individual provider Active NPI

Liljana Licovski, DPM

  • Primary Podiatric Medicine Podiatrist
  • Brownstown TWP, MI
National Provider Identifier
1568469500
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
5901001880 Issued in MI
Practice address
19723 Allen Rd
Brownstown TWP, MI 48183-1021
Phone
(734) 479-8383
Fax
(734) 479-8382
NPI assigned
Jul 6, 2005
Last updated
Dec 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 5901001880 MI Primary

Addresses

Primary practice location

19723 Allen Rd
Brownstown TWP, MI 48183-1021

Mailing address

19723 Allen Road
Brownstown, MI 48183
Phone (734) 479-8383

Other identifiers 1

IdentifierTypeStateIssuer
3515935MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100123000120 MI Practitioner - Podiatry 6709928112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vicki Anton Anthens DPM PCGroup PAC ID 8921049800, 4 clinicians

Practice addresses (Care Compare)

19723 Allen Rd
Brownstown TWP, MI 48183-1021
Phone (734) 479-8383

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.54 of 100Reported as group
Quality
78.5
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions187
Removal of nail tissue639
Removal or shaving of skin growth16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Vicki Anton Anthens DPM PC CurrentSince Mar 1, 1999 Accepting new patients
Giaimo Mobile Podiatry of WV PLLC Past Accepting new patients
James W Hill PastSince Mar 1, 1999 Accepting new patients

Locations

19723 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-8383

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1568469500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19723 ALLEN ROAD",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "48183",
            "telephone_number": "734-479-8383",
            "fax_number": "734-479-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19723 ALLEN RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831021",
            "telephone_number": "734-479-8383",
            "fax_number": "734-479-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICOVSKI",
        "first_name": "LILJANA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-06",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "MI",
            "license": "5901001880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3515935",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown TWP, MI

Sources for this page

Verify at the official NPI Registry.