Liborio L Lira, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20943 Issued in MN

Practice address

3501 Douglas Dr N
Crystal, MN 55422-2480

Phone

(764) 535-9601

Fax

(763) 535-5601

NPI assigned

Jun 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Osseo Clinic, P.a.

  • Family Medicine Physician
  • Osseo, MN
  • NPI 1588764765
  NPD (past)

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1427054287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 CENTRAL AVE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691245",
            "telephone_number": "763-425-2117",
            "fax_number": "763-425-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 DOUGLAS DR N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554222480",
            "telephone_number": "764-535-9601",
            "fax_number": "763-535-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRA",
        "first_name": "LIBORIO",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "20943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "843570700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Albrecht Lee, PHYSICIAN ASSISTANT
• Lisa Legvold, PA-C
• William Leon, D.D.S.
• Jennifer Ann Liane
• Lionsgate Academy
• Ann Margaret Lish-Mitch, O.T.R.
• Connor Litfin
• Loving Homes Inc.
• Loyalty Home Healthcare, LLC
• Emily Lund, MD

• General Practice Physician in Crystal, MN
• Providers in Crystal, MN by specialty
• General Practice Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.