David Nathan Lieberman, M.D., PH.D.

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

268306 Issued in MA

Practice address

300 Longwood Avenue
Department of Neurology, Fegan 11
Boston, MA 02115

Phone

(617) 355-2063

Fax

(617) 730-0288

NPI assigned

Jun 22, 2006

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

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Neurology

Education

Stanford University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

C H Neurology Foundation IncGroup PAC ID 5496744195, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dlieberman66153@direct.bostonchildrens.org

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.

• C H Neurology Foundation Inc

  • Neurology with Special Qualifications in Child Neurology Physician
  • Boston, MA
  • NPI 1063432417
  Medicare reassignment Care Compare group NPD
• C H Neurology Foundation, Inc

  • Developmental - Behavioral Pediatrics Physician
  • Boston, MA
  • NPI 1215120258
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1457397770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVENUE",
            "address_2": "DEPARTMENT OF NEUROLOGY, FEGAN 11",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021153213",
            "telephone_number": "617-355-2063",
            "fax_number": "617-730-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVENUE",
            "address_2": "DEPARTMENT OF NEUROLOGY, FEGAN 11",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-355-2063",
            "fax_number": "617-730-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "DAVID",
        "middle_name": "NATHAN",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MA",
            "license": "268306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hart GW Lidov, MD, PHD
• Margaret Lie, MD
• Sui an Lie, MD
• James G Liebau, ANP
• Patricia Jeanne Lieber, LICSW
• Evan Emanuel Lieberman, MD
• Gillian Lieberman
• Graham Michael Lieberman, MD, MBA
• Judy Lieberman, MD, PHD
• Sarah Lieberman, DPT

• Neurology with Special Qualifications in Child Neurology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.