Individual provider Active NPI

Ann K. Lieberman, O.D.

  • Optometrist
  • Fayetteville, NC
National Provider Identifier
1770519514
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1498 Issued in NC
Practice address
1635A Owen Dr
Fayetteville, NC 28304-3425
Phone
(910) 483-2020
NPI assigned
Jun 23, 2006
Last updated
Feb 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1498 NC Primary

Addresses

Primary practice location

1635A Owen Dr
Fayetteville, NC 28304-3425

Mailing address

1635A Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 483-2020

Other identifiers 2

IdentifierTypeStateIssuer
890907FMedicaidNC
0907FOtherNCBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000356 NC Practitioner - Optometry 7012955065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

327 S 5TH St
Saint Pauls, NC 28384-1741
Phone (910) 865-9800

Merit-based Incentive Payment System (MIPS)

Final score
88.58 of 100Reported as group
Quality
77.16
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lieberman & Lieberman Optometry, PLLC Optometrist CurrentSince Aug 1, 1996 Accepting new patients
Lieberman & Lieberman Optometry, PLLC Optometrist CurrentSince May 1, 2002 Accepting new patients

Locations

1635A Owen Dr
Fayetteville, NC 28304
Phone (910) 323-2002

327 S 5th St
Saint Pauls, NC 28384
Phone (910) 865-9800

Interoperability endpoints

  • Direct secure messaging: annlieberman@direct.revolutionehr.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.

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1770519514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635A OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-483-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635A OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-483-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "ANN",
        "middle_name": "K.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890907F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0907F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.