Individual provider Active NPI

Lawrence S. Liebman, M.D.

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1033377478
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
148303-1 Issued in NY
Practice address
3600 Minnesota Dr
Edina, MN 55435-7979
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
May 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 311118 LA
Diagnostic Radiology Physician 2085R0202X 148303-1 NY Primary

Addresses

Primary practice location

3600 Minnesota Dr
Edina, MN 55435-7979

Mailing address

3600 Minnesota Dr
Edina, MN 55435-7979
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX, WA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180830001361 NY Practitioner - Diagnostic Radiology 4183974827 Reassigns benefits to 10 organizations
I20180907001162 TX Practitioner - Diagnostic Radiology 4183974827 Reassigns benefits to 5 organizations
I20250717004118 WA Practitioner - Diagnostic Radiology 4183974827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Jersey Radiology Associates P aGroup PAC ID 9133115587, 202 clinicians
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Sonoran Radiology LTDGroup PAC ID 3375964505, 466 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians
Virtual Radiologic Professionals of New York PAGroup PAC ID 9335244169, 27 clinicians

Practice addresses (Care Compare)

New York, NY 10162
Phone (856) 229-0696

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3480

167 Main St
Tcrhcc Mobile Medical Clinic
Tuba City, AZ 86045-0600
Phone (928) 283-2501

167 N Main St
Tuba City, AZ 86045-0600
Phone (928) 283-2094

5 Harrison CT
Cortlandt Manor, NY 10567-7022
Phone (623) 299-8743

500 E 77TH St
Apt 524
New York, NY 10162-0002
Phone (952) 595-1100

845 United Nations PLZ
Apt 47D
New York, NY 10017-3535
Phone (832) 915-2534

P O Box
Suite 600
Tuba City, AZ 86045-0600

Hospital & facility affiliations

  • Bassett Healthcare Hospital, Cooperstown, NY, CCN 330136
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
148303NYMDLicensed Practical Nurse
311118LAMDDiagnostic Radiology Physician
148303-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baker Community Health Center Inc CurrentSince Jun 29, 2019 Accepting new patients
Pacific County Hospital District 2 Current Accepting new patients
Ton San Xavier Health Center CurrentSince Aug 6, 2018 Accepting new patients
Tuba City Regional Health Care Corporation Current Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Apr 28, 2021 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Dec 19, 2022 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Jan 27, 2020 Accepting new patients
Radiology Associates of Burlington County P a Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Icahn School of Medicine at Mount Sinai Diagnostic Radiology CurrentSince Jan 1, 2021 Accepting new patients
Ton Sells Hospital CurrentSince Aug 6, 2018 Accepting new patients
Regents of the Univ of Ca Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Claremont Imaging Associates, a Medical Corporation Diagnostic Radiology CurrentSince Jun 10, 2024 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Sep 16, 2018 Accepting new patients
Virtual Radiologic Professionals of New York, P.a. Diagnostic Radiology CurrentSince Aug 6, 2018 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Sep 16, 2018 Accepting new patients
South Jersey Radiology Associates P a Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Dec 19, 2022 Accepting new patients
Ton San Simon Health Center CurrentSince Aug 6, 2018 Accepting new patients
Virtual Radiologic Professionals of Texas I, P.a. Diagnostic Radiology PastSince Mar 20, 2025 Accepting new patients
Tulane University Medical Group Past Accepting new patients
Ton San Xavier Health Center Past Accepting new patients
Ton Sells Hospital Past Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1800 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-6285

1405 S Alma School Rd
Chandler, AZ 85286
Phone (480) 256-7000

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

37000 N Gantzel Rd
San Tan Valley, AZ 85140
Phone (480) 394-4000

7900 S J Stock Rd
Tucson, AZ 85746
Phone (520) 295-2550

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

4868 X St
Sacramento, CA 95817
Phone (916) 703-1503

11995 Singletree Ln
Ste 500
Eden Prairie, MN 55344
Phone (952) 595-1143

3600 Minnesota Dr
Ste 800
Minneapolis, MN 55435
Phone (612) 595-1100

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

130 North St
Walton, NY 13856
Phone (607) 865-6541

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFJBA
  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1033377478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357979",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357979",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMAN",
        "first_name": "LAWRENCE",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "311118",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "148303-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.