Active NPI
Mark Lieberman, MD
- Emergency Medicine Physician
- Coral Springs, FL
National Provider Identifier
1780670588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- ME 54945
- Practice address
- 3000 Coral Hills Dr
Coral Springs Medical Center - Ed
Coral Springs, FL 33065-4108 - Phone
- (954) 344-3000
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | ME 54945 | FL | Primary |
Addresses
Primary practice location
3000 Coral Hills Dr
Coral Springs Medical Center - Ed
Coral Springs, FL 33065-4108
Mailing address
6245 NW 104TH Way
Parkland, FL 33076-2359
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09093 | Other | FL | MEDICARE CORE |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 54945 | FL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paragon Contracting Services LLC | Emergency Medicine | Current | Accepting new patients |
Locations
2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277
901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300
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": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386892800000",
"number": "1780670588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6245 NW 104TH WAY",
"city": "PARKLAND",
"state": "FL",
"postal_code": "330762359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 CORAL HILLS DR",
"address_2": "CORAL SPRINGS MEDICAL CENTER - ED",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330654108",
"telephone_number": "954-344-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMAN",
"first_name": "MARK",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2013-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "ME 54945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE CORE",
"identifier": "09093",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.