Individual provider Active NPI

Arlen Jay Lieberman, DC

  • Chiropractor
  • Golden Valley, MN
National Provider Identifier
1659367308
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
001754 Issued in MN
Practice address
5685 Duluth St
Golden Valley, MN 55422-4054
Phone
(763) 541-1280
Fax
(763) 541-1012
NPI assigned
Sep 27, 2005
Last updated
Mar 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001754 MN Primary

Addresses

Primary practice location

5685 Duluth St
Golden Valley, MN 55422-4054

Mailing address

5801 Duluth St
Ste 150
Golden Valley, MN 55422-3952
Phone (763) 541-1280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000432 MN Practitioner - Chiropractic 3173557147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Medical of Twin Cities, P.C.Group PAC ID 9436137643, 2 clinicians

Practice addresses (Care Compare)

8441 Wayzata Blvd
Suite 300
Golden Valley, MN 55426-1357
Phone (763) 541-1280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001754MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical of Twin Cities, P.C. CurrentSince May 14, 1998 Accepting new patients

Locations

8441 Wayzata Blvd
Ste 300
Golden Valley, MN 55426
Phone (763) 541-1280

5685 Duluth St
Minneapolis, MN 55422
Phone (612) 541-1280

5801 Duluth St
Ste 150
Minneapolis, MN 55422
Phone (763) 541-1280

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1659367308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 DULUTH ST",
            "address_2": "STE 150",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554223952",
            "telephone_number": "763-541-1280",
            "fax_number": "763-541-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 DULUTH ST",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224054",
            "telephone_number": "763-541-1280",
            "fax_number": "763-541-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "ARLEN",
        "middle_name": "JAY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "001754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.