Individual provider Active NPI

Rebekah Lieberman, APRN

  • Family Nurse Practitioner
  • Saint Johns, FL
National Provider Identifier
1720838121
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11020594 Issued in FL
Practice address
2050 Saint Johns Pkwy Ste 109
Saint Johns, FL 32259-4593
Phone
(954) 815-4321
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11020594 FL Primary

Addresses

Primary practice location

2050 Saint Johns Pkwy Ste 109
Saint Johns, FL 32259-4593

Mailing address

2050 Saint Johns Pkwy Ste 109
Saint Johns, FL 32259-4593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703003563 FL Practitioner - Nurse Practitioner 5294279097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Florida Atlantic University, College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Infusion Services LLCGroup PAC ID 4688578826, 60 clinicians

Practice addresses (Care Compare)

2050 Saint Johns Pkwy
Suite 109
St Johns, FL 32259-4593
Phone (800) 809-1265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11020594FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Infusion Services LLC CurrentSince Jun 23, 2025 Accepting new patients

Locations

1825 Kingsley Ave
Ste 201
Orange Park, FL 32073

2050 Saint Johns Pkwy
Ste 109
St Johns, FL 32259
Phone (954) 815-4321

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.

NPI Registry JSON

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1720838121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 SAINT JOHNS PKWY STE 109",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 SAINT JOHNS PKWY STE 109",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594593",
            "telephone_number": "954-815-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "REBEKAH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11020594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

Verify at the official NPI Registry.