NPIMap

Organization Active NPI

Liberty Endoscopy, LLC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
National Provider Identifier
1689029316
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
LIBERTY ENDOSCOPY, LLC
Practice address
156 William St
4TH Floor
New York, NY 10038
Phone
(646) 215-2244
Fax
(646) 215-2245
NPI assigned
May 2, 2016
Last updated
Nov 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Juliana De Campos
Title
Administrator
Phone
(646) 215-2244

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

156 William St
4TH Floor
New York, NY 10038

Mailing address

156 William St FL 4
New York, NY 10038-2609
Phone (646) 215-2244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161213000174 NY Part B Supplier - Ambulatory Surgical Center 8426338245 Receives reassigned benefits from 39 practitioners
Practice locations: New York, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Liberty Endoscopy CenterCCN 33C0001166
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1689029316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 WILLIAM ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382609",
            "telephone_number": "646-215-2244",
            "fax_number": "646-215-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 WILLIAM ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10038",
            "telephone_number": "646-215-2244",
            "fax_number": "646-215-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY ENDOSCOPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "DE CAMPOS",
        "authorized_official_first_name": "JULIANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "646-215-2244"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.