NPIMap

Individual provider Active NPI

Douglas B Lieberman, MD

  • Internal Medicine Physician
  • Media, PA
National Provider Identifier
1932289113
Registry record updated Nov 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD060365L Issued in PA
Practice address
200 E State St Ste 106
Media, PA 19063-3434
Phone
(610) 872-8040
Fax
(610) 499-5995
NPI assigned
Oct 16, 2006
Last updated
Nov 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD060365L PA Primary

Addresses

Primary practice location

200 E State St Ste 106
Media, PA 19063-3434

Mailing address

200 E State St Ste 106
Media, PA 19063-3434
Phone (610) 872-8040

Other identifiers 1

IdentifierTypeStateIssuer
1101303MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028000815 PA Practitioner - Internal Medicine 0042404519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians
Bell and Conrad Corp PAGroup PAC ID 2062496003, 2 clinicians

Practice addresses (Care Compare)

201 2ND Ave
Collegeville, PA 19426-3613
Phone (610) 489-7703

30 Medical Ctr Blvd
Pob 1 Suite 403
Chester, PA 19013-3955

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bell and Conrad Corp PA Internal Medicine CurrentSince Dec 4, 1978 Accepting new patients
Prospect CCMC, LLC Past Accepting new patients

Locations

30 Medical Center Blvd
Ste 102
Chester, PA 19013
Phone (610) 872-5621

30 Medical Center Blvd
Ste 403
Chester, PA 19013
Phone (610) 872-8040

200 E State St
Ste 106
Media, PA 19063
Phone (610) 480-5176

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bayada HospiceNewtown Square, PA, CCN 391741 Hospice W-2 Managing Employee Jul 22, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1932289113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E STATE ST STE 106",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633434",
            "telephone_number": "610-872-8040",
            "fax_number": "610-499-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E STATE ST STE 106",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633434",
            "telephone_number": "610-872-8040",
            "fax_number": "610-499-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD060365L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1101303",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.