Daniel James Liebertz, M.D.

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

60671191 Issued in WA

Practice address

5209 Lake Washington Blvd NE
Ste 115
Kirkland, WA 98033-7355

Phone

(425) 822-0300

Fax

(425) 822-4999

NPI assigned

Jul 6, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 19, 2017 through Sep 19, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Yarrow Bay Plastic Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Kirkland, WA
  • NPI 1215249941

  Facial Plastic Surgery

  NPD Authorized official
• Yarrow Bay Plastic Surgery, PLLC

  • Facial Plastic Surgery Physician
  • Kirkland, WA
  • NPI 1588611552
  NPD Authorized official

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1740592849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 LAKE WASHINGTON BLVD NE",
            "address_2": "STE 115",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337355",
            "telephone_number": "425-822-0300",
            "fax_number": "425-822-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 LAKE WASHINGTON BLVD NE",
            "address_2": "STE 115",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980337355",
            "telephone_number": "425-822-0300",
            "fax_number": "425-822-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERTZ",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "GA",
            "license": "073020",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WA",
            "license": "60671191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiaojiao Li
• Xue Li
• Ying-Hui Li, RPH
• Glenn Mark Libman, PT
• Jessica M Lichtenstein, PHARMD.
• Elissa Lierley, CDP
• Anne McLaurin Likosky, MD
• David Jack Likosky, MD
• Ryan Lilley, MD
• Breanna Lee Lillibridge

• Facial Plastic Surgery Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Facial Plastic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.