NPIMap

Individual provider Active NPI

Leedor Lieberman

  • Internal Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1548796881
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301506665 Issued in MI
Practice address
32255 Northwestern Hwy Ste 214
Farmington Hills, MI 48334-1573
Phone
(248) 855-5620
NPI assigned
May 5, 2017
Last updated
Jul 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301506665 MI Primary

Addresses

Primary practice location

32255 Northwestern Hwy Ste 214
Farmington Hills, MI 48334-1573

Mailing address

29992 Northwestern Hwy Ste C
Farmington Hills, MI 48334-3292
Phone (947) 221-9684

Other practice location 1

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220408001900 MI Practitioner - Endocrinology 9234525791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Wayne State University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

32255 Northwestern Hwy
Suite 214
Farmington Hills, MI 48334-1573
Phone (248) 855-5620

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301506665MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC Internal Medicine CurrentSince Apr 1, 2022 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Apr 1, 2022 Accepting new patients

Locations

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

30000 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 470-2190

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

32255 Northwestern Hwy
Ste 214
Farmington Hills, MI 48334
Phone (248) 855-5620

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1548796881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "947-221-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32255 NORTHWESTERN HWY STE 214",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341573",
            "telephone_number": "248-855-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044238",
            "country_code": "US",
            "telephone_number": "215-662-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "LEEDOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301506665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.