Edgardo Mesias Livica, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

015653 Issued in NY

Practice address

787 Lydig Ave
Bronx, NY 10462-2144

Phone

(718) 775-6025

NPI assigned

Sep 25, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1669468666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 LURTING AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611509",
            "telephone_number": "718-822-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 LYDIG AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104622144",
            "telephone_number": "718-775-6025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2510 Westchester Ave",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104613512",
            "country_code": "US",
            "telephone_number": "718-775-6025",
            "fax_number": "718-822-8490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIVICA",
        "first_name": "EDGARDO",
        "middle_name": "MESIAS",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-25",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "015653",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02716585",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0129225",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2558827",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yi Liu, MD, PHD
• Anna Liveris, MD
• Jkuan Liverpool
• Livewell Pharmacy Inc
• Livica Physical Therapy P.C.
• Eena Kaela Cimanes Livica, PT, ATC, CSCS, RYT
• Angela Rosa Livingston, M.S., CCC-SLP
• Shelley G. Livingston, LPN
• Carol Anne Livoti, M.D.,F.A.C.O.G.
• Jazel Liz

• Physical Therapist in Bronx, NY
• Providers in Bronx, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.