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MR. JUSTIN MICHAEL LIDDY PA-C
NPI 1780154443
Physician Assistant in Mahwah, NJ

Active since November 26, 2018PECOS EnrolledAccepts Medicare Assignment
1400 MACARTHUR BLVD, MAHWAH, NJ 07430(201) 316-8431(201) 962-9735 Get Directions Write a Review

NPPES record last updated: November 26, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Justin Michael Liddy Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JUSTIN MICHAEL LIDDY PA-C (NPI 1780154443) is an individual physician assistant in Mahwah, New Jersey, licensed in New Jersey (25MP00500100) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS, is affiliated with Main Line Hospital Lankenau, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1780154443
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. JUSTIN MICHAEL LIDDYCredential: PA-C
Location Address1400 MACARTHUR BLVDMahwah, NJ 07430-3618
Mailing Address716 Wilson CtRiver Vale, NJ 07675-6345 · (201) 664-2597
Phone(201) 316-8431
Fax(201) 962-9735
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateNovember 26, 2018
✔ NPI 1780154443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NJ · 25MP00500100
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
1400 MACARTHUR BLVD, Mahwah, NJ 07430
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Justin Michael Liddy Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID941548762
PECOS Enrollment IDI20221027002751
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Main Line Hospital Lankenau

Acute Care Hospitals · Wynnewood, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390195
Location100 Lancaster AveWynnewood, PA 19096 · Montgomery County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07430 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ORTHONJ LLC
Durable Medical Equipment & Medical Supplies
1400 MACARTHUR BLVD
MAHWAH, NJ 07430
Bergen County (201) 316-8449
JOHN SUNGHO KIM
Physical Therapist
1400 MACARTHUR BLVD
MAHWAH, NJ 07430
Bergen County (201) 447-8134
MS. MARIA GEMMA WILLIAMS FNP
Nurse Practitioner (Family)
1400 MACARTHUR BLVD
MAHWAH, NJ 07430
Bergen County (973) 706-0238
HANNAH DIAL DPT
Physical Therapist
1400 MACARTHUR BLVD
MAHWAH, NJ 07430
Bergen County (201) 447-8134
THE VALLEY HOSPITAL INC.
Pharmacy (Community/Retail Pharmacy)
1400 MACARTHUR BLVD
MAHWAH, NJ 07430
Bergen County (201) 316-8444

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Liddy's NPI number?

The NPI number for Justin Liddy is 1780154443. It was assigned to this individual provider in the NPPES registry on November 26, 2018.

Where is Justin Liddy located?

Justin Liddy practices at 1400 Macarthur Blvd, Mahwah, NJ 07430. The listed phone number is (201) 316-8431.

What is Justin Liddy's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Justin Liddy enrolled in Medicare?

Yes. Justin Liddy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Justin Liddy affiliated with any hospitals?

According to CMS data, Justin Liddy is affiliated with Main Line Hospital Lankenau.

When was this NPI record last updated?

The NPPES record for Justin Liddy was last updated on November 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.