Individual provider Active NPI

Paul Jason Liswood, DPM

  • Foot Surgery Podiatrist
  • Brooklyn, NY
National Provider Identifier
1740394600
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
NOO5182 Issued in NY
Practice address
7212 4TH Ave
Brooklyn, NY 11209-2552
Phone
(718) 745-0256
Fax
(718) 833-0505
NPI assigned
Aug 18, 2006
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X NOO5182 NY Primary

Addresses

Primary practice location

7212 4TH Ave
Brooklyn, NY 11209-2552

Mailing address

7212 4TH Ave
Brooklyn, NY 11209-2552
Phone (718) 745-0256

Other identifiers 1

IdentifierTypeStateIssuer
02012820MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110216000054 NY Practitioner - Podiatry 6709098734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions13
Removal of nail tissue317
Removal or shaving of skin growth28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NOO5182NYMDFoot Surgery Podiatrist
005182NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Optum Urgent Care, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

555 N Broadway
Jericho, NY 11753
Phone (516) 597-5070

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

2800 Marcus Ave
New Hyde Park, NY 11042
Phone (516) 622-6131

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: paulliswood@mai.allscriptsdirect.net

Organizations & group practices 6

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1740394600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092552",
            "telephone_number": "718-745-0256",
            "fax_number": "718-833-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092552",
            "telephone_number": "718-745-0256",
            "fax_number": "718-833-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISWOOD",
        "first_name": "PAUL",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "NOO5182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02012820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.