Individual provider Active NPI

Kristin A Lieberman, MD

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1053413708
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
59175 Issued in MN
Practice address
2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905
Phone
(651) 292-2000
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 59175 MN Primary

Addresses

Primary practice location

2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905

Mailing address

2355 Highway 36 W
Ste 100
Roseville, MN 55113-3905
Phone (651) 292-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN, ND, FL4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20040429001336 WI Practitioner - Diagnostic Radiology 0648267682 Reassigns benefits to 5 organizations
I20150410001347 MN Practitioner - Diagnostic Radiology 0648267682 Reassigns benefits to 23 organizations
I20220902002525 ND Practitioner - Diagnostic Radiology 0648267682 Reassigns benefits to 3 organizations
I20230906002026 FL Practitioner - Diagnostic Radiology 0648267682 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Wisconsin School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lutheran Charity AssociationGroup PAC ID 2264341031, 168 clinicians
Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians
Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians
Marshfield Clinic IncGroup PAC ID 2264345206, 207 clinicians
Altru Health SystemGroup PAC ID 1355251604, 675 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Practice addresses (Care Compare)

Estero, FL 34135
Phone (701) 952-1050

155 Radio Dr
Woodbury, MN 55125-2619
Phone (952) 831-8742

1601 Golf Course Rd
Grand Rapids, MN 55744-8648
Phone (218) 326-3401

1617 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6600

166 E 4TH St
Suite 100
St Paul, MN 55101-1421
Phone (651) 292-2000

23206 Oakglen LN
Estero, FL 34135-2008
Phone (800) 782-8581

2355 Hwy 36 W
Suite 100
Roseville, MN 55113-3905
Phone (651) 292-2000

2450 Riverside Ave
Minneapolis, MN 55454-1450

411 Stageline Rd
Hudson, WI 54016-7848
Phone (952) 831-8742

420 E 1St St
Duluth, MN 55805-1901
Phone (218) 786-8364

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

750 E 34TH St
Hibbing, MN 55746-4600
Phone (218) 262-4881

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph'S Hospital and Health Center Current Accepting new patients
Allina Health System Current Accepting new patients
Altru Health System CurrentSince Apr 1, 2015 Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Fairview Clinics CurrentSince Sep 29, 2021 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2019 Accepting new patients
Fairview Clinics CurrentSince Sep 29, 2021 Accepting new patients
Suburban Imaging, LLC CurrentSince Mar 1, 2019 Accepting new patients
Tria Orthopaedic Center LLC Diagnostic Radiology CurrentSince Jul 11, 2023 Accepting new patients
Allina Health System CurrentSince May 1, 2015 Accepting new patients
Lac Qui Parle Clinic of Madison Inc CurrentSince Mar 2, 2024 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Madison Healthcare Services CurrentSince Apr 14, 2024 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
Altru Health System CurrentSince Apr 1, 2015 Accepting new patients
Range Regional Health Services CurrentSince Jan 1, 2025 Accepting new patients
Tria Orthopaedic Center LLC Diagnostic Radiology CurrentSince Jul 11, 2023 Accepting new patients
Allina Health System CurrentSince May 1, 2015 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics Current Accepting new patients
Allina Health System Current Accepting new patients
St. Croix Regional Medical Center CurrentSince Nov 1, 2018 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Feb 20, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Pembina County Memorial Hospital Association CurrentSince May 1, 2015 Accepting new patients
P R Health Corporation Current Accepting new patients
St. Croix Regional Medical Center CurrentSince Nov 1, 2018 Accepting new patients
St Joseph'S Hospital and Health Center Current Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Dec 7, 2022 Accepting new patients
Hutchinson Health CurrentSince Jan 1, 2022 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Range Regional Health Services CurrentSince Jan 1, 2025 Accepting new patients
Midwest Radiology Outpatient Imaging, LLC Diagnostic Radiology CurrentSince Apr 1, 2015 Accepting new patients
Ridgeview Medical Center Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
The Duluth Clinic LTD CurrentSince Feb 20, 2023 Accepting new patients
Grand Itasca Clinic and Hospital CurrentSince Feb 1, 2025 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 1, 2022 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
St Josephs Hospital and Health Center CurrentSince Dec 7, 2022 Accepting new patients
Towner County Medical Center Inc CurrentSince Sep 11, 2015 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Allina Health System CurrentSince Jun 1, 2016 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 15, 2019 Accepting new patients
Lutheran Charity Association Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Healthpartners RC Current Accepting new patients
Park Nicollet Clinic CurrentSince Jan 1, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 15, 2019 Accepting new patients
University Radiology Associates, LLP Diagnostic Radiology Past Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Mar 1, 2019 Accepting new patients
Range Regional Health Services Past Accepting new patients

Locations (25 of 56)

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

14000 Nicollet Ave
Ste 204
Burnsville, MN 55337
Phone (952) 898-2333

111 Hundertmark Rd
Ste 130
Chaska, MN 55318
Phone (952) 456-7400

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

420 E 1st St
Duluth, MN 55805
Phone (218) 786-1265

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

111 SE 3rd St
Grand Rapids, MN 55744
Phone (218) 326-3401

1601 Golf Course Rd
Grand Rapids, MN 55744
Phone (218) 326-3401

750 E 34th St
Hibbing, MN 55746
Phone (218) 262-3441

3605 Mayfair Ave
Hibbing, MN 55746
Phone (218) 262-3441

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

1095 Highway 15 S
Hutchinson, MN 55350
Phone (320) 234-5000

820 3rd Ave
Madison, MN 56256
Phone (320) 598-3552

900 2nd Ave
Madison, MN 56256
Phone (320) 598-7536

12000 Elm Creek Blvd N
Ste 310
Maple Grove, MN 55369
Phone (763) 416-7888

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

2945 Hazelwood St
Ste 110
Maplewood, MN 55109

11850 Blackfoot St NW
Ste 180
Minneapolis, MN 55433
Phone (763) 795-1600

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

Organizations & group practices 57

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.

View all 57

Hospital & facility affiliations 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1053413708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "59175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.