Individual provider Active NPI

Jeremy Isaac Lieb, M.D.

  • Urology Physician
  • Concord, CA
National Provider Identifier
1093713190
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
A79348 Issued in CA
Practice address
2222 East St
Ste 250
Concord, CA 94520-2084
Phone
(925) 689-6211
Fax
(925) 689-3857
NPI assigned
Jul 12, 2005
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X A79348 CA Primary

Addresses

Primary practice location

2222 East St
Ste 250
Concord, CA 94520-2084

Mailing address

1450 Treat Blvd # 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2828

Other identifiers 1

IdentifierTypeStateIssuer
GR0067920MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100201000395 CA Practitioner - Urology 4880693647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Rochester School of Medicine and Dentistry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

2400 Balfour Rd
Suite 230
Brentwood, CA 94513-4957
Phone (925) 671-0610

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.32 of 100Reported as group
Quality
89.54
Promoting interoperability
100
Improvement activities
40
Cost
74.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A79348CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
John Muir Physician Network CurrentSince Aug 13, 2021 Accepting new patients
John Muir Trauma Physicians Billing Service Urology CurrentSince Dec 23, 2009 Accepting new patients
Sutter Delta Medical Center Past Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients
San Ramon Regional Medical Center, LLC Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

2400 Balfour Rd
Ste 230
Brentwood, CA 94513
Phone (925) 324-7404

2222 East St
Ste 250
Concord, CA 94520
Phone (925) 609-7220

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

400 Taylor Blvd
Ste 105
Pleasant Hill, CA 94523
Phone (925) 687-2570

400 Taylor Blvd
Ste 202
Pleasant Hill, CA 94523
Phone (925) 932-4567

100 N Wiget Ln
Ste 290
Walnut Creek, CA 94598

1450 Treat Blvd
#300
Walnut Creek, CA 94597
Phone (925) 952-2828

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: jlieb17998@ehr.johnmuirhealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1093713190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD # 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 EAST ST",
            "address_2": "STE 250",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202084",
            "telephone_number": "925-689-6211",
            "fax_number": "925-689-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEB",
        "first_name": "JEREMY",
        "middle_name": "ISAAC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "A79348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0067920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.