Individual provider Active NPI

Jared J Liebman, M.D.

  • Plastic Surgery Physician
  • Philadelphia, PA
National Provider Identifier
1760692180
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD433333 Issued in PA
Practice address
5401 Old York Rd
Klein 101
Philadelphia, PA 19141-3030
Phone
(215) 456-7890
NPI assigned
May 23, 2007
Last updated
Aug 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD433333 PA Primary

Addresses

Primary practice location

5401 Old York Rd
Klein 101
Philadelphia, PA 19141-3030

Mailing address

PO Box 8500-8735
Philadelphia, PA 19178-8735
Phone (215) 456-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120912000728 PA Practitioner - Plastic and Reconstructive Surgery 1658529821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Einstein Practice Plan IncGroup PAC ID 2769395896, 774 clinicians

Practice addresses (Care Compare)

60 E Township Line Rd
Elkins Park, PA 19027-2220
Phone (215) 663-6800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD433333PAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc CurrentSince Aug 15, 2012 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Aug 15, 2012 Accepting new patients
Einstein Practice Plan Inc Past Accepting new patients

Locations

60 Township Line Rd
Elkins Park, PA 19027
Phone (215) 663-6000

5401 Old York Rd
Ste 101
Philadelphia, PA 19141
Phone (215) 456-6178

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

5501 York Rd
Ste 202
Philadelphia, PA 19141
Phone (215) 254-2630

9880 Bustleton Ave
Ste 205
Philadelphia, PA 19115
Phone (215) 676-2222

9880 Bustleton Ave
Ste 308
Philadelphia, PA 19115
Phone (215) 342-9554

Interoperability endpoints

  • Direct secure messaging: jared.liebman@direct.einstein.edu

Organizations & group practices 4

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1760692180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-8735",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191788735",
            "telephone_number": "215-456-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD YORK RD",
            "address_2": "KLEIN 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413030",
            "telephone_number": "215-456-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBMAN",
        "first_name": "JARED",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD433333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.