DR. TIMOTHY JOSEPH LIEBERENZ (OD) – Optometrist, NPI 1205613783

DR. TIMOTHY JOSEPH LIEBERENZ (OD) is a healthcare provider. based in Merlin, Oregon. specializing in OPTOMETRY. They hold the professional credentials OD. They hold a License No. ATI4707 (OR). The NPI Number for DR. TIMOTHY JOSEPH LIEBERENZ (OD) is 1205613783

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
DR. TIMOTHY JOSEPH LIEBERENZ (OD)
NPI
1205613783
Phone
(541) 279-4792
Address
PO BOX 1082
Enumeration Date
11 September 2023
Last Update Date
11 September 2023

Doctor Profile

Medical School Name
PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Secondary Phone
5413435555
Graduation Year
2023 (3 years ago)
PAC ID
6002352655
Group Practice PAC ID
6406843598
Professional Enrollment ID
I20240719001432
Address ID
OR974023625EU1740XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

672 OPTOMETRY in OR

Provider Addresses for DR. TIMOTHY JOSEPH LIEBERENZ (OD)

  • PO BOX 1082

    MERLIN, OR 975321082

    Phone: (541) 279-4792

    Type: Mailing

  • 8495 CRATER LAKE HWY

    WHITE CITY, OR 975033011

    Phone: (541) 826-2111

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $121.

Total Amount is formed as General ($121) + Research ($0) + Ownership ($0) = $121.

Last reported payment date: 2024-10-10 • Largest payer in this snapshot: Glaukos Corporation ($121).

Total Amount

$121

General + Research + Ownership

Payments

1

Total payment records

General Amount

$121

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-10

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Glaukos Corporation$121
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240719001432IOptometryORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97532)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406843598View full group profile

Reviews

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Frequently asked questions

What identifier follows DR. TIMOTHY JOSEPH LIEBERENZ (OD) across health systems?
The NPI 1205613783 uniquely identifies DR. TIMOTHY JOSEPH LIEBERENZ (OD) in U.S. healthcare data.
Does the public listing show DR. TIMOTHY JOSEPH LIEBERENZ (OD) as active?
DR. TIMOTHY JOSEPH LIEBERENZ (OD)'s NPI record reflects an active status in NPPES.
Which specialty label fits DR. TIMOTHY JOSEPH LIEBERENZ (OD)?
NPPES ties DR. TIMOTHY JOSEPH LIEBERENZ (OD) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to DR. TIMOTHY JOSEPH LIEBERENZ (OD)?
DR. TIMOTHY JOSEPH LIEBERENZ (OD) shows a connection to Merlin, Oregon in registry-derived data.
Why is information missing for DR. TIMOTHY JOSEPH LIEBERENZ (OD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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