Individual provider Active NPI

Howard S Lieberman, DC

  • Chiropractor
  • Cortland, NY
National Provider Identifier
1922095371
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005049 Issued in NY
Practice address
120 Tompkins St
Cortland, NY 13045-2429
Phone
(607) 753-1884
Fax
(607) 753-1540
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005049 NY Primary

Addresses

Primary practice location

120 Tompkins St
Cortland, NY 13045-2429

Mailing address

120 Tompkins St
Cortland, NY 13045-2429
Phone (607) 753-1884

Other identifiers 1

IdentifierTypeStateIssuer
51400COtherPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090721000067 NY Practitioner - Chiropractic 6901957679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back to Health ChiropracticGroup PAC ID 2466503131, 2 clinicians

Practice addresses (Care Compare)

120 Tompkins St
Cortland, NY 13045-2429
Phone (607) 753-1884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005049NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back to Health Chiropractic Chiropractor CurrentSince Nov 1, 1988 Accepting new patients

Locations

10 Groton Ave
Cortland, NY 13045
Phone (607) 753-1884

120 Tompkins St
Cortland, NY 13045
Phone (607) 753-1884

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1922095371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 TOMPKINS ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452429",
            "telephone_number": "607-753-1884",
            "fax_number": "607-753-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TOMPKINS ST",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452429",
            "telephone_number": "607-753-1884",
            "fax_number": "607-753-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "HOWARD",
        "middle_name": "S",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "51400C",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.