Individual provider Active NPI

Myron Liebhaber, M.D.

  • Allergy & Immunology Physician
  • Santa Barbara, CA
National Provider Identifier
1346253390
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
G25873 Issued in CA
Practice address
215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone
(805) 681-1761
Fax
(805) 681-1768
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X G25873 CA Primary

Addresses

Primary practice location

215 Pesetas LN
Santa Barbara, CA 93110-1416

Mailing address

PO Box 62106
Santa Barbara, CA 93160-2106
Phone (805) 681-1761

Other identifiers 1

IdentifierTypeStateIssuer
00G258730MedicaidCA

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
I20101004001284 CA Practitioner - Allergy/Immunology 3476745803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Arizona College of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sansum ClinicGroup PAC ID 3678471976, 320 clinicians

Practice addresses (Care Compare)

215 Pesetas LN
Santa Barbara, CA 93110-1416
Phone (805) 681-7800

51 Hitchcock Way
Santa Barbara, CA 93105-3101
Phone (805) 563-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25873CAMDGeneral Practice Dentistry
G25873CAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic Current Accepting new patients
Sansum Clinic CurrentSince Sep 1, 1977 Accepting new patients
Sansum Clinic CurrentSince Sep 1, 1977 Accepting new patients
Goleta Valley Cottage Hospital Past Accepting new patients
Santa Barbara Cottage Hospital Past Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

51 Hitchcock Way
Santa Barbara, CA 93105
Phone (805) 563-6100

Interoperability endpoints

  • Direct secure messaging: mliebhaber760606@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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 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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1346253390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62106",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931602106",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PESETAS LN",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931101416",
            "telephone_number": "805-681-1761",
            "fax_number": "805-681-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBHABER",
        "first_name": "MYRON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "G25873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G258730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.