Angelina Liddy, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

MT224340 Issued in PA

Practice address

10800 Knights Rd
Philadelphia, PA 19114-4200

Phone

(215) 612-5161

NPI assigned

Jun 23, 2021

Sex

Female

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Infectious DiseaseAlso: Hospitalist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Infectious Diseases Associates, P.C.

  • Infectious Disease Physician
  • Southampton, PA
  • NPI 1225092117
  Medicare reassignment

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1891364790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 KNIGHTS RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191144200",
            "telephone_number": "215-612-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDY",
        "first_name": "ANGELINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT224340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Licker, M.D.
• Lauren E. Licwinko, CRNP
• Mary Ann Licwinko, CRNA
• Stephanie Lidd, M.D.
• Elizabeth Anne Liddell, POM
• Robert Liebenberg, MD
• Cory Gail Lieber, PA-C
• Alexis Sloan Lieberman, M.D.
• David Lieberman, M.S., C.G.C.
• David Michael Lieberman, LCSW

• Student in an Organized Health Care Education/Training Program in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Student in an Organized Health Care Education/Training Program in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.