Individual provider Active NPI

Susan Linda Lieberman, PT

  • Physical Therapist
  • Boca Raton, FL
National Provider Identifier
1093975195
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT10164 Issued in FL
Practice address
3250 NW 63Rd St
Boca Raton, FL 33496-3312
Phone
(561) 866-3956
Fax
(561) 241-1631
NPI assigned
Jun 11, 2008
Last updated
Jun 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT10164 FL Primary

Addresses

Primary practice location

3250 NW 63Rd St
Boca Raton, FL 33496-3312

Mailing address

3250 NW 63Rd St
Boca Raton, FL 33496-3312
Phone (561) 866-3956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081112000733 FL Practitioner - Physical Therapist in Private Practice 2860551322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Therapy by Design LLCGroup PAC ID 6608844170, 12 clinicians

Practice addresses (Care Compare)

1905 Clint Moore Rd
Suite 102
Boca Raton, FL 33496-5834

1905 Clint Moore Rd
Suite 305
Boca Raton, FL 33496-2661
Phone (561) 994-0014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy by Design LLC Physical Therapist CurrentSince Jun 11, 2008 Accepting new patients

Locations

1905 Clint Moore Rd
Ste 102
Boca Raton, FL 33496
Phone (561) 994-0014

1905 Clint Moore Rd
Ste 305
Boca Raton, FL 33496
Phone (561) 208-5515

10151 Entrprs Cntr Blvd
Ste 104
Boynton Beach, FL 33437
Phone (561) 572-3220

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1093975195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 NW 63RD ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963312",
            "telephone_number": "561-866-3956",
            "fax_number": "561-241-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 NW 63RD ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334963312",
            "telephone_number": "561-866-3956",
            "fax_number": "561-241-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "SUSAN",
        "middle_name": "LINDA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.