Individual provider Active NPI

Justin Scott Liberman, MD

  • Anesthesiology Physician
  • Seattle, WA
National Provider Identifier
1194083949
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD61025358 Issued in WA
Practice address
925 Seneca St
H8-Gme
Seattle, WA 98101-2742
Phone
(206) 583-6079
Fax
(206) 583-2307
NPI assigned
Apr 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 54041 TN
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X MD61025358 WA Primary

Addresses

Primary practice location

925 Seneca St
H8-Gme
Seattle, WA 98101-2742

Mailing address

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 583-6079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20200618002951 WA Practitioner - Anesthesiology 6103062021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arizona College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61025358WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center CurrentSince Jul 9, 2020 Accepting new patients
Virginia Mason Medical Center Anesthesiology CurrentSince Jul 9, 2020 Accepting new patients

Locations

925 Seneca St
#H8
Seattle, WA 98101
Phone (206) 515-5811

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

Interoperability endpoints

  • Direct secure messaging: justin.liberman@direct.vmmc.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1194083949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-583-6079",
            "fax_number": "206-583-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SENECA ST",
            "address_2": "H8-GME",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012742",
            "telephone_number": "206-583-6079",
            "fax_number": "206-583-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERMAN",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "54041",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD61025358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.