Active NPI
Bryan - Lieberman, M.D.
- Neurology Physician
- Norwood, MA
National Provider Identifier
1114916533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 38491
- Practice address
- 825 Washington St
Suite 115
Norwood, MA 02062-3441 - Phone
- (781) 769-0465
- Fax
- (781) 769-4696
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 38491 | MA | Primary |
Addresses
Primary practice location
825 Washington St
Suite 115
Norwood, MA 02062-3441
Mailing address
145 Gay St
Westwood, MA 02090-2596
Phone (781) 329-5642
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2061511 | Medicaid | MA | |
| K02087 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38491 | MA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Norwood Hospital, Inc. | Past | Accepting new patients | |
| Agustin M Florian, MD, PC | Past | Accepting new patients | |
| Caritas Norwood Hospital | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Norwood, MA
- NPI 1942395454
-
- Specialist
- Norwood, MA
- NPI 1578872263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114916533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 GAY ST",
"city": "WESTWOOD",
"state": "MA",
"postal_code": "020902596",
"telephone_number": "781-329-5642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 WASHINGTON ST",
"address_2": "SUITE 115",
"city": "NORWOOD",
"state": "MA",
"postal_code": "020623441",
"telephone_number": "781-769-0465",
"fax_number": "781-769-4696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMAN",
"first_name": "BRYAN",
"middle_name": "-",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "38491",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2061511",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "K02087",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwood, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.