Liberty Health Supply, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LIBERTY HEALTH SUPPLY, INC

Practice address

1099 Jay St
Suite E
Rochester, NY 14611-1153

Phone

(585) 235-1370

Fax

(585) 235-1385

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Kozak

Title

Office Manager

Phone

(585) 235-1370

Specialties & licenses 4

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1902855729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 JAY ST",
            "address_2": "SUITE E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146111153",
            "telephone_number": "585-235-1370",
            "fax_number": "585-235-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1099 JAY ST",
            "address_2": "SUITE E",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146111153",
            "telephone_number": "585-235-1370",
            "fax_number": "585-235-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY HEALTH SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "KOZAK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "585-235-1370",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1302050",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS PROVIDER #",
            "identifier": "LHE109146",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "8201631",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02068413",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE PROVIDER #",
            "identifier": "103644",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE PROVIDER #",
            "identifier": "P0170059CM",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Liano, MD
• Xiaoyan Liao, M.D, ,PH.D.
• Hania Liaqat, MD
• Anissa Mary Libardi, LCSW
• Jeffrey A Liberman, DO
• Marc S Libman, M.D.
• Karina Marie Licata
• Katherine Licata, PA
• Marshall Albert Lichtman, M.D.
• Emilie Liddle, MS, RDN

• Durable Medical Equipment & Medical Supplies in Rochester, NY
• Providers in Rochester, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.