Active NPI
Robert Terrence Liberto, MD
- Internal Medicine Physician
- Baltimore, MD
National Provider Identifier
1639193980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D0021464
- Practice address
- 3508 Bank St
Baltimore, MD 21224-2303 - Phone
- (410) 732-8819
- NPI assigned
- Jul 27, 2006
- Last updated
- Jun 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0021464 | MD | Primary |
Addresses
Primary practice location
3508 Bank St
Baltimore, MD 21224-2303
Mailing address
3508 Bank St
Baltimore, MD 21224-2303
Phone (410) 732-8819
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 786751400 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0021464 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland Family Care, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654
2525 Pot Spring Rd
Timonium, MD 21093
Phone (410) 308-9702
Interoperability endpoints
- rliberto130979@direct.umm.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1639193980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3508 BANK ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212242303",
"telephone_number": "410-732-8819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3508 BANK ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212242303",
"telephone_number": "410-732-8819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBERTO",
"first_name": "ROBERT",
"middle_name": "TERRENCE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0021464",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "786751400",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
- Paulina Liberman Salazar, MD
- Amanda Rachel Liberman
- Bernard Liberman, PHD
- Liberte Pain & Wellness Center LLC
- Joseph Gregory Liberto, M.D.
- Liberty Heights Wabash Dolfield Consolidated Trust CDC Inc (LWD Consolidated Trust CDC)
- Liberty Leasing Co., LLC (BridgePark Healthcare Center)
- Liberty Medical & Injury Center
- Liberty Medical &Injury Center
- Liberty Medical Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.