Individual provider Active NPI

R.Jude Liptak, AUD.

  • Audiologist
  • Williamsburg, VA
National Provider Identifier
1568598274
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001149 Issued in VA
Practice address
430 McLaws Cir
Suite 101
Williamsburg, VA 23185-5655
Phone
(757) 229-4004
Fax
(757) 229-9992
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001149 VA Primary

Addresses

Primary practice location

430 McLaws Cir
Suite 101
Williamsburg, VA 23185-5655

Mailing address

430 McLaws Cir
Suite 101
Williamsburg, VA 23185-5655
Phone (757) 229-4004

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080514000424 VA Practitioner - Qualified Audiologist 1153490370 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Colonial Center for Hearing Inc Audiologist CurrentSince May 1, 2008 Accepting new patients
Advanced ENT & Allergy, PC CurrentSince Nov 20, 2021 Accepting new patients
Hampton Roads Otolaryngology Associates PLLC Past Accepting new patients

Locations

11842 Rock Landing Dr
Ste 100
Newport News, VA 23606
Phone (757) 873-0338

430 McLaws Cir
Ste 101
Williamsburg, VA 23185
Phone (757) 229-4004

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12840/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jude.liptak.1@12840.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1568598274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MCLAWS CIR",
            "address_2": "SUITE 101",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855655",
            "telephone_number": "757-229-4004",
            "fax_number": "757-229-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MCLAWS CIR",
            "address_2": "SUITE 101",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855655",
            "telephone_number": "757-229-4004",
            "fax_number": "757-229-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTAK",
        "first_name": "R.JUDE",
        "name_prefix": "Dr.",
        "credential": "AUD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.