Individual provider Active NPI

Alicia Liberatore

  • Nurse Practitioner
  • Saint Petersburg, FL
National Provider Identifier
1619725470
Registry record updated May 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11032662 Issued in FL
Practice address
1839 Central Ave
Saint Petersburg, FL 33713-8900
Phone
(878) 201-3312
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X APRN11032662 FL Primary

Addresses

Primary practice location

1839 Central Ave
Saint Petersburg, FL 33713-8900

Mailing address

1839 Central Ave
Saint Petersburg, FL 33713-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241107003631 FL Practitioner - Nurse Practitioner 4981138310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Pcma Palliative Division LLCGroup PAC ID 1456613637, 72 clinicians

Practice addresses (Care Compare)

4833 Fruitville Rd
Unit 101
Sarasota, FL 34232-1885
Phone (878) 201-3312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pcma Palliative Division LLC Single Specialty CurrentSince Aug 29, 2024 Accepting new patients

Locations

2000 Cliffmine Rd
Ste 500
Pittsburgh, PA 15275
Phone (724) 766-0025

Organizations & group practices 1

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1619725470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337138900",
            "telephone_number": "878-201-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERATORE",
        "first_name": "ALICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11032662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

Verify at the official NPI Registry.