Jordan Taylor Liebman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3180 Main St Ste 301
Bridgeport, CT 06606-4237

Phone

(203) 373-9100

NPI assigned

Jan 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, HI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Mill Hill Medical Consultants Inc

  • Hospitalist Physician
  • Greenwich, CT
  • NPI 1841520293
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1760198386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5059 MAGNOLIA BAY CIR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334186733",
            "telephone_number": "561-401-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 MAIN ST STE 301",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064237",
            "telephone_number": "203-373-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMAN",
        "first_name": "JORDAN",
        "middle_name": "TAYLOR",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Wenyu Liaw, MD
• Liberation Programs Inc
• Liberation Programs Inc
• Alex S Liddar, CRNA
• Dara Lieberson, MS, CLGC
• Linda Liefland, PHD
• Lifebridge Community Services, Inc.
• Lifestyle Homecare Services
• Mark Edwin Lightowler II, PA-C
• John Salvatore Lignore, PA-C

• Physician Assistant in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.