Individual provider Active NPI

Harry Andres Liberman, M.D.

  • Colon & Rectal Surgery Physician
  • Marietta, GA
National Provider Identifier
1669440806
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
048665 Issued in GA
Practice address
780 Canton Rd NE
Suite 315
Marietta, GA 30060-7241
Phone
(770) 794-7203
Fax
(770) 794-7204
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 048665 GA Primary

Addresses

Primary practice location

780 Canton Rd NE
Suite 315
Marietta, GA 30060-7241

Mailing address

5667 Peachtree Dunwoody Rd NE
Suite 330
Atlanta, GA 30342-1725
Phone (404) 252-5669

Other identifiers 1

IdentifierTypeStateIssuer
00870141AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20081021000144 GA Practitioner - Colorectal Surgery (Proctology) 9830290196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570

2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274

2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

780 Canton Rd NE
Marietta, GA 30060-8928

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy85
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Apr 20, 2015 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 20, 2015 Accepting new patients
Northside Surgical Professional Services LLC PastSince Aug 15, 2015 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

590 Nancy St NW
Marietta, GA 30060
Phone (770) 423-0395

800 Canton Rd NE
Marietta, GA 30060
Phone (770) 424-4328

Interoperability endpoints

  • Direct secure messaging: hliberman62039@directwellstar.org

Organizations & group practices 4

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 3

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1669440806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5667 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 330",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421725",
            "telephone_number": "404-252-5669",
            "fax_number": "404-252-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CANTON RD NE",
            "address_2": "SUITE 315",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607241",
            "telephone_number": "770-794-7203",
            "fax_number": "770-794-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERMAN",
        "first_name": "HARRY",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "048665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00870141A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.