Organization Active NPI

Liakeas Medical PC

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1912729914
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIAKEAS MEDICAL PC
Practice address
180 E 79TH St # 1C
New York, NY 10075-0437
Phone
(646) 564-2900
Fax
(646) 328-0804
NPI assigned
Oct 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
George Liakeas, MDNPI 1417049727
Title
President
Phone
(646) 564-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

180 E 79TH St # 1C
New York, NY 10075-0437

Mailing address

180 E 79TH St # 1C
New York, NY 10075-0437
Phone (646) 564-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241218000091 NY Part B Supplier - Clinic/Group Practice 0648707448 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2334129Liakeas Medical PC180 East 79TH St 1C, New York, NY 10075Certificate of waiverNov 16, 2027

National Provider Directory

National Provider Directory

Locations

9835 Lake Worth Rd
Ste 16385
Lake Worth, FL 33467
Phone (646) 564-2900

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1912729914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E 79TH ST # 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750437",
            "telephone_number": "646-564-2900",
            "fax_number": "646-328-0804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E 79TH ST # 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750437",
            "telephone_number": "646-564-2900",
            "fax_number": "646-328-0804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIAKEAS MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "LIAKEAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-564-2900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.