Perry Melvin Lieberman, OD
Individual provider
Active NPI
Optometrist · Minerva, OH
NPI 1225016058 · NPPES record last updated Dec 24, 2008
Key facts
- NPI
- 1225016058
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3077T541 (OH)
- Practice address
- 206 N Market St
Minerva, OH 44657-1616
- Phone
- (330) 868-5506
- Fax
- (330) 868-6483
- NPI assigned
- Jan 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 and National Provider Directory roles.
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern California College of Optometry, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
206 N Market St
Minerva, OH 44657-1673
Phone (330) 868-5506
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|
| Cataract surgery | 16 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| I20120607000058 |
OH |
Practitioner - Optometry |
3375658834 |
Practice locations: Minerva, OH |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|
| 3077 | OH | MD | Chiropractor |
| 3077T541 | OH | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|
| Perry M Lieberman OD |
Optometrist |
Past
since Jun 19, 1973 |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
| Optometrist |
152W00000X |
3077T541 |
OH |
Yes |
Addresses
Primary practice location
206 N Market St
Minerva, OH 44657-1616
Mailing address
206 N Market St
Minerva, OH 44657-1616
Phone (330) 868-5506
Other identifiers
| Identifier | Type | State | Issuer |
|---|
| 341176988 | Other | OH | AULTCARE |
| 7912 | Other | OH | VSP PROVIDER NO |
| 000000128177 | Other | OH | ANTHEM |
| 61854 | Other | OH | SPECTERA |
| 000000128178 | Other | OH | AETNA |
| 7111 | Other | OH | DAVIS VISION |
| 86988 | Other | OH | AFSME |
| 360378 | Other | OH | NVA |
| E00341176988 | Other | OH | AETNA |
| 000000128178 | Other | OH | ANTHEM |
| 3174328 | Other | OH | CIGNA |
| 341176988-003 | Other | OH | MEDICAL MUTUAL |
| 341176988026 | Other | OH | PROVIDER NO |
| 11129 | Other | OH | COAST TO COAST |
| 6939 | Other | OH | VSP CANTON |
| 7129 | Other | OH | DAVIS VISION |
| 0236784 | Medicaid | OH | |
| 111837 | Other | OH | EYEMED |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (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.