William Nathan Lisberg, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

28413 Issued in MN

Practice address

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Phone

(763) 559-2171

Fax

(763) 694-9000

NPI assigned

Jul 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Tria Orthopaedic Center LLC

  • Ambulatory Surgical Clinic/Center
  • Minneapolis, MN
  • NPI 1053314013
  NPD
• Tria Orthopaedic Center LLC

  dba TRIA Orthopaedic Clinic

  • Orthopaedic Surgery Physician
  • Bloomington, MN
  • NPI 1518273085

  Diagnostic Radiology

  NPD

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1003816075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR",
            "address_2": "#10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412645",
            "telephone_number": "763-559-2171",
            "fax_number": "763-694-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-559-2171",
            "fax_number": "763-694-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISBERG",
        "first_name": "WILLIAM",
        "middle_name": "NATHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "28413",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MN",
            "license": "28413",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MN",
            "license": "28413",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MN",
            "license": "28413",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MN",
            "license": "28413",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "893072400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Marie Richards Lindstrom, PT
• Kristen Joy Lindvall, PA-C
• Andrew Allan Link, PA-C
• Lions Gym Inc (Lions Gym and Wellness Center)
• Abby Kathryn Lipanot, OTR/L
• Alan W Litts, MD
• Erving Wayne London, CNP
• Delaney Long, MS, RD, PA-C
• Troy Dean Long, MD
• Amy E Look, PH.D.

• Diagnostic Radiology Physician in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.

Verify at the official NPI Registry.