Nicole C Liebertz, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP60659234 Issued in WA

Practice address

1959 NE Pacific St
Seattle, WA 98195

Phone

(206) 520-5000

NPI assigned

Dec 11, 2012

Last updated

Aug 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nicole M Cardenas Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paceline Anesthesia, PLLCGroup PAC ID 5799853099, 36 clinicians

Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paceline Anesthesia, PLLC

  • Certified Registered Nurse Anesthetist
  • Bellevue, WA
  • NPI 1417273780

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Evergreen Eye Anesthesia PLLC

  • Certified Registered Nurse Anesthetist
  • Federal Way, WA
  • NPI 1134839319

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Matrix Anesthesia, PS

  • Anesthesiology Physician
  • Bellevue, WA
  • NPI 1831146422
  NPD
• Washington Gastroenterology PLLC

  dba Washington Gastroenterology Lab

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1467011122
  NPD

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1528303997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3005 112th Ave NE Ste 210",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980048010",
            "country_code": "US",
            "telephone_number": "810-300-4950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERTZ",
        "first_name": "NICOLE",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60659234",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60659233",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528303997",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "CARDENAS",
            "middle_name": "M",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Mitchell Lieberman, MD
• Martin Lieberman, DDS
• Mary Ann Lieberman, PSY. D
• Scott Liebert
• Stephanie Stamnes Liebert, MD
• Matthew Liechty, ARNP
• Heather Liedl, PA-C
• Kimberly K Liekweg, MD
• Andrea Liem, O.D.
• Brian C Liem, MD

• Certified Registered Nurse Anesthetist in Seattle, WA
• Providers in Seattle, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.