Individual provider Active NPI

Celerina Mary Joyce Liwag, MD

  • Pediatrics Physician
  • Ephrata, PA
National Provider Identifier
1992761456
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD417725 Issued in PA
Practice address
159 North Reading Rd
Baca Pediatrics
Ephrata, PA 17522-1671
Phone
(717) 733-0790
Fax
(717) 733-1802
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD417725 PA Primary

Addresses

Primary practice location

159 North Reading Rd
Baca Pediatrics
Ephrata, PA 17522-1671

Mailing address

159 North Reading Rd
Baca Pediatrics
Ephrata, PA 17522-1671
Phone (717) 733-0790

Other identifiers 2

IdentifierTypeStateIssuer
0018947580002MedicaidPA
50038237OtherCAPITAL BLUE CROSS

Other names 1

  • Celerina Mary Joyce Pugeda Liwag Other name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20111115000791 PA Practitioner - Pediatric Medicine 8628242336 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD417725PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Hospital Current Accepting new patients
Reading Hospital CurrentSince Nov 6, 2011 Accepting new patients
Reading Hospital CurrentSince Nov 6, 2011 Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Jul 1, 2017 Accepting new patients
Reading Hospital Pediatrics Past Accepting new patients
Baca Pediatrics Pediatrics Past Accepting new patients
Tower Health Medical Group Past Accepting new patients

Locations

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

2101 State Hill Rd
Ste 6
Wyomissing, PA 19610
Phone (610) 898-9380

Organizations & group practices 9

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1992761456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 NORTH READING RD",
            "address_2": "BACA PEDIATRICS",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221671",
            "telephone_number": "717-733-0790",
            "fax_number": "717-733-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 NORTH READING RD",
            "address_2": "BACA PEDIATRICS",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221671",
            "telephone_number": "717-733-0790",
            "fax_number": "717-733-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIWAG",
        "first_name": "CELERINA",
        "middle_name": "MARY JOYCE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD417725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018947580002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50038237",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CELERINA",
            "last_name": "LIWAG",
            "middle_name": "MARY JOYCE PUGEDA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.