Individual provider Active NPI

Angela Maria Liquori, PA-C

  • Physician Assistant
  • Avon, CT
National Provider Identifier
1871164988
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6727 Issued in CT
Practice address
385 W Main St
Avon, CT 06001-4357
Phone
(860) 777-1280
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA8225 MA
Physician Assistant 363A00000X 6727 CT Primary

Addresses

Primary practice location

385 W Main St
Avon, CT 06001-4357

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other practice location 1

471 Center St
Ludlow, MA 01056-2733
Phone (413) 625-3500

Other names 1

  • Angela Maria Ferrentino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241023002744 CT Practitioner - Physician Assistant 4284026279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Urgent Care Centers LLCGroup PAC ID 7618242777, 201 clinicians

Practice addresses (Care Compare)

385 W Main St
Avon, CT 06001-4357
Phone (860) 777-6977

54 Hazard Ave
Enfield, CT 06082-3845
Phone (860) 787-5780

7 Mill Pond Dr
Suite a
Granby, CT 06035-2637
Phone (860) 323-3164

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as group
Quality
85.61
Promoting interoperability
100
Improvement activities
40
Cost
46.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6727CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: angela.liquori@xdr.hhchealthdirect.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1871164988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 W MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014357",
            "telephone_number": "860-777-1280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "471 Center St",
            "address_purpose": "LOCATION",
            "city": "Ludlow",
            "state": "MA",
            "postal_code": "010562733",
            "country_code": "US",
            "telephone_number": "413-625-3500",
            "fax_number": "413-625-3655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIQUORI",
        "first_name": "ANGELA",
        "middle_name": "MARIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8225",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "FERRENTINO",
            "middle_name": "MARIA",
            "credential": "MS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Avon, CT

Sources for this page

Verify at the official NPI Registry.