Individual provider Active NPI

Leonardo Liberman, MD

  • Pediatric Cardiology Physician
  • New York, NY
National Provider Identifier
1962480319
Registry record updated May 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
X001234 Issued in NY
Practice address
3959 Broadway
New York, NY 10032-1559
Phone
(212) 305-7250
Fax
(212) 544-1974
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X X001234 NY Primary
Clinical Cardiac Electrophysiology Physician 207RC0001X 251536 NY

Addresses

Primary practice location

3959 Broadway
New York, NY 10032-1559

Mailing address

3959 Broadway
New York, NY 10032-1559
Phone (212) 350-7250

Other identifiers 1

IdentifierTypeStateIssuer
02212944MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110131000891 NY Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 1153500574 Reassigns benefits to 3 organizations
I20180719002707 NJ Practitioner - Pediatric Medicine 1153500574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
251536NYMDClinical Cardiac Electrophysiology Physician
X001234NYMDPediatric Cardiology Physician
001234NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2018 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 9, 2018 Accepting new patients
Columbia Doctors of New Jersey, P. C. CurrentSince Jun 9, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 1, 2018 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

400 Kelby St
Ste 9
Fort Lee, NJ 07024

400 Kelby St
Fort Lee, NJ 07024
Phone (212) 304-6309

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

3959 Broadway
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

630 W 168th St
#112
New York, NY 10032
Phone (212) 304-7297

622 W 168th St
#4C408
New York, NY 10032
Phone (646) 317-7111

2026 Richmond Rd
Staten Island, NY 10306
Phone (212) 305-2300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: liberma@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 7

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1962480319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-350-7250",
            "fax_number": "212-544-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-7250",
            "fax_number": "212-544-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERMAN",
        "first_name": "LEONARDO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "X001234",
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NY",
            "license": "251536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02212944",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.