Arlen Jay Lieberman, DC

Individual provider Active NPI Chiropractor · Golden Valley, MN

NPI 1659367308 · NPPES record last updated Mar 27, 2017

Key facts

NPI
1659367308
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
001754 (MN)
Practice address
5685 Duluth St
Golden Valley, MN 55422-4054
Phone
(763) 541-1280
Fax
(763) 541-1012
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

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. (2 clinicians)

Practice addresses (Care Compare)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
001754MNMDChiropractor

Practice roles

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

Locations

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

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

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 001754 MN Yes

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

Other identifiers

IdentifierTypeStateIssuer
754727700MedicaidMN
09841LIOtherMNBCBS

Other providers in Golden Valley, MN

All providers in Golden Valley, MN · Chiropractor in Minnesota

Sources for this page

Verify at the official NPI Registry.