NPIMap

Organization Active NPI

Liberty Surgical Associates

  • Surgery Physician
  • Jersey City, NJ
National Provider Identifier
1689606956
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
LIBERTY SURGICAL ASSOCIATES
Practice address
377 Jersey Avenue
Suite 220
Jersey City, NJ 07302-4396
Phone
(201) 309-2380
Fax
(201) 309-2381
NPI assigned
Jul 7, 2006
Last updated
Jan 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Helen M Kennedy
Title
Corporate Director, Physician Servi
Phone
(201) 521-5934

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary
Trauma Surgery Physician 2086S0127X NU
Colon & Rectal Surgery Physician 208C00000X NU

Addresses

Primary practice location

377 Jersey Avenue
Suite 220
Jersey City, NJ 07302-4396

Mailing address

355 Grand Street
Jersey City, NJ 07302-4321
Phone (201) 915-2450

Other identifiers 1

IdentifierTypeStateIssuer
6603700MedicaidNJ

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1689606956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 GRAND STREET",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "201-915-2450",
            "fax_number": "201-915-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVENUE",
            "address_2": "SUITE 220",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024396",
            "telephone_number": "201-309-2380",
            "fax_number": "201-309-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR, PHYSICIAN SERVI",
        "authorized_official_telephone_number": "201-521-5934"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.