Individual provider Active NPI

Jacob Lieb, M.D.

  • Emergency Medicine Physician
  • Sheridan, WY
National Provider Identifier
1679763791
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
8452A Issued in WY
Practice address
1401 W 5TH St
Sheridan, WY 82801-2705
Phone
(307) 672-1000
NPI assigned
Jul 25, 2007
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 81892 AZ
Emergency Medicine Physician 207P00000X 8452A WY Primary

Addresses

Primary practice location

1401 W 5TH St
Sheridan, WY 82801-2705

Mailing address

1401 W 5TH St
Sheridan, WY 82801-2705
Phone (307) 672-1000

Other practice location 1

780 N Richey Blvd # 1
Tucson, AZ 85716-4689
Phone (307) 760-8323

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jacoblieb@sheridan.cernerdirect.com Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100921000304 WY Practitioner - Emergency Medicine 8729103254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Washington School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1401 W 5TH St
Sheridan, WY 82801-2705
Phone (307) 672-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.21 of 100Reported as group
Quality
80.49
Promoting interoperability
94
Improvement activities
40
Cost
68.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81892AZMDEmergency Medicine Physician
8452AWYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Sheridan County CurrentSince Jul 18, 2010 Accepting new patients
Memorial Hospital of Sheridan County Emergency Medicine CurrentSince Jul 18, 2010 Accepting new patients

Locations

1401 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000

Interoperability endpoints

  • Direct secure messaging: jacoblieb@sheridan.cernerdirect.com

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 1

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1679763791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W 5TH ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012705",
            "telephone_number": "307-672-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W 5TH ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012705",
            "telephone_number": "307-672-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 N Richey Blvd # 1",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857164689",
            "country_code": "US",
            "telephone_number": "307-760-8323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEB",
        "first_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-25",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "81892",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "8452A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacoblieb@sheridan.cernerdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1401 W 5th St",
            "city": "Sheridan",
            "state": "WY",
            "country_code": "US",
            "postal_code": "828012705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.