Mark Lieberman, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

890 Bedford Ave
Brooklyn, NY 11205-4251

Phone

(718) 218-6089

NPI assigned

Nov 16, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

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.

• The Bedside Dentist LLC

  • General Practice Dentistry
  • Elizabeth, NJ
  • NPI 1316224215
  NPD (past) Authorized official

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

{
    "created_epoch": "1416096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1902202138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 KIMBALL ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344512",
            "telephone_number": "718-859-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054251",
            "telephone_number": "718-218-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "MARK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-16",
        "last_updated": "2021-07-22",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Lieberman, M.D.
• Dawn Lieberman
• Jacob Lieberman, DDS
• Libby Lieberman, SLP-CCC
• Mark Lieberman, CRNA
• Matthew S Lieberman, DMD
• Melissa Kate Lieberman, P.T.
• Mindy Lieberman
• Miriam Lieberman
• Rivka Lieberman

• Medical Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.