Individual provider Active NPI

Dean Lieberman, PA-C

  • Physician Assistant
  • Atlantis, FL
National Provider Identifier
1407864143
Registry record updated May 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9100994 Issued in FL
Practice address
5507 S Congress Ave
Suite 150
Atlantis, FL 33462-1139
Phone
(561) 433-4444
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9100994 FL Primary

Addresses

Primary practice location

5507 S Congress Ave
Suite 150
Atlantis, FL 33462-1139

Mailing address

5507 S Congress Ave
Suite 150
Atlantis, FL 33462-1139
Phone (561) 433-4444

Other identifiers 1

IdentifierTypeStateIssuer
290660100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040726001262 FL Practitioner - Physician Assistant 9234109554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

1697 W Indiantown Rd
Jupiter, FL 33458-3979
Phone (561) 420-8555

4570 Lantana Rd
Lake Worth, FL 33463-6908
Phone (561) 963-9881

5240 Donald Ross Rd
Palm Beach Gardens, FL 33418-7258
Phone (561) 786-5887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9100994FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach Neurosurgery LLC Past Accepting new patients
MD Now Medical Centers Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242604800000",
    "number": "1407864143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5507 S CONGRESS AVE",
            "address_2": "SUITE 150",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621139",
            "telephone_number": "561-433-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5507 S CONGRESS AVE",
            "address_2": "SUITE 150",
            "city": "ATLANTIS",
            "state": "FL",
            "postal_code": "334621139",
            "telephone_number": "561-433-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2009-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9100994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290660100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantis, FL

Sources for this page

Verify at the official NPI Registry.