Individual provider Active NPI

Cheryl A Liechty, MD

  • Internal Medicine Physician
  • Rockport, ME
National Provider Identifier
1609845452
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
016825 Issued in ME
Practice address
4 Glen Cove Dr
Ste 202
Rockport, ME 04856
Phone
(207) 593-5800
Fax
(207) 593-5322
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 016825 ME Primary
Infectious Disease Physician 207RI0200X 016825 ME

Addresses

Primary practice location

4 Glen Cove Dr
Ste 202
Rockport, ME 04856

Mailing address

4 Glen Cove Dr
Ste 202
Rockport, ME 04856
Phone (207) 593-5800

Other identifiers 1

IdentifierTypeStateIssuer
431875499MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20050718000245 ME Practitioner - Internal MedicinePractitioner - Infectious Disease 0244266625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Icahn School of Medicine at Mount Sinai, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

4 Glen Cove Dr
Rockport, ME 04856-4236

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (207) 921-8969

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016825MEMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Bay Physicians & Associates CurrentSince Jul 1, 2005 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Internal Medicine Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

4 Glen Cove Dr
Ste 202
Rockport, ME 04856
Phone (207) 593-5800

4 Glen Cove Dr
Ste 5
Rockport, ME 04856
Phone (207) 592-5883

4 Glen Cove Dr
Ste 201
Rockport, ME 04856
Phone (207) 301-5757

3 Glen Cove Dr
#3
Rockport, ME 04856
Phone (207) 301-5400

4 Glen Cove Dr
Ste 102
Rockport, ME 04856
Phone (207) 593-5757

Interoperability endpoints

  • Direct secure messaging: cliechty10684@direct.mmc.mainehealth.org

Organizations & group practices 5

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 4

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1609845452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GLEN COVE DR",
            "address_2": "STE 202",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "04856",
            "telephone_number": "207-593-5800",
            "fax_number": "207-593-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GLEN COVE DR",
            "address_2": "STE 202",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "04856",
            "telephone_number": "207-593-5800",
            "fax_number": "207-593-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIECHTY",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "016825",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "ME",
            "license": "016825",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431875499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

Verify at the official NPI Registry.