Samuel Lizerbram, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS002814L Issued in PA

Practice address

12000 Bustleton Ave
Suite 102
Philadelphia, PA 19116-2151

Phone

(215) 673-7600

Fax

(215) 673-1894

NPI assigned

Apr 6, 2006

Last updated

Apr 7, 2015By the provider in NPPES

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

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Temple Physicians Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1942444088
  Medicare reassignment NPD
• Dr Samuel Lizerbram & Dr Neil M Cohen PC

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1437190238
  Authorized official Same address or phone
• Temple Physician Inc.

  • Internal Medicine Physician
  • Feasterville Trevose, PA
  • NPI 1174497366
  NPD
• Temple Physicians Inc.

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
  • NPI 1558413948
  NPD

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1568424109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151",
            "telephone_number": "215-673-7600",
            "fax_number": "215-673-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 BUSTLETON AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162151",
            "telephone_number": "215-673-7600",
            "fax_number": "215-673-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZERBRAM",
        "first_name": "SAMUEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS002814L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000696256001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katarzyna Liwski, D.O.
• Myryan A. Lizama
• Ramiro Wladimir Lizano Santamaria, M.D.
• Odilia Lizardo, MA
• Bruce Lizerbram, D.O.
• Gunnar Vatana Ljungqvist, MD
• LK Pharmacy Inc (Best Care Pharmacy II)
• LKV Dental Sleep Medicine LLC
• January Llaverias, CASE MANAGER
• Jeanne Llenado, D.O.

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.