NPIMap

Individual provider Active NPI

Burton A Liebross, M.D.

  • Nephrology Physician
  • Tarzana, CA
National Provider Identifier
1659350718
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
G32169 Issued in CA
Practice address
5525 Etiwanda Ave
Suite 320
Tarzana, CA 91356-3647
Phone
(818) 774-3838
Fax
(818) 774-3590
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G32169 CA
Nephrology Physician 207RN0300X G32169 CA Primary

Addresses

Primary practice location

5525 Etiwanda Ave
Suite 320
Tarzana, CA 91356-3647

Mailing address

5805 Sepulveda Blvd
Suite 610
Van Nuys, CA 91411-2546
Phone (818) 908-8048

Other identifiers 1

IdentifierTypeStateIssuer
95-3629679OtherCATAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100617000112 CA Practitioner - NephrologyPractitioner - Internal Medicine 4880723188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

18321 Clark St
Tarzana, CA 91356-3501
Phone (818) 881-0800

5525 Etiwanda Ave
Suite 320
Tarzana, CA 91356-6130
Phone (818) 774-3839

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Oct 15, 2014 Accepting new patients
Michael S. Malamed, M.D., a Medical Corporation Internal Medicine Current Accepting new patients
Kamyar Kamjoo MD a Medical Corporation Nephrology Current Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Tarzana Medical Center LLC Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Yaroslav a. Gofnung, M.D., Inc. Past Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

5525 Etiwanda Ave
Ste 320
Tarzana, CA 91356
Phone (818) 774-3838

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

15211 Vanowen St
Ste 315
Van Nuys, CA 91405
Phone (818) 785-1645

15211 Vanowen St
Ste 300
Van Nuys, CA 91405
Phone (818) 782-4104

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: bliebross198210@direct.cshs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 7

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1659350718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 SEPULVEDA BLVD",
            "address_2": "SUITE 610",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914112546",
            "telephone_number": "818-908-8048",
            "fax_number": "818-908-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 ETIWANDA AVE",
            "address_2": "SUITE 320",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563647",
            "telephone_number": "818-774-3838",
            "fax_number": "818-774-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBROSS",
        "first_name": "BURTON",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G32169",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "G32169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "95-3629679",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.