Individual provider Active NPI

Jeremiah J. Libby, DO

  • Diagnostic Radiology Physician
  • Minocqua, WI
National Provider Identifier
1184045213
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
71074 Issued in WI
Practice address
9576 Highway 70
Minocqua, WI 54548-9067
Phone
(715) 358-1000
NPI assigned
Dec 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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 71074 WI Primary

Addresses

Primary practice location

9576 Highway 70
Minocqua, WI 54548-9067

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 1

6500 38th Ave N
St Petersburg, FL 33710-1629
Phone (727) 341-4819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20180827001153 NC Practitioner - Diagnostic Radiology 3173872041 Reassigns benefits to 1 organization
I20190723002893 WI Practitioner - Diagnostic Radiology 3173872041 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern New Hampshire Radiology Consultants PCGroup PAC ID 2769436088, 39 clinicians

Practice addresses (Care Compare)

1091 Old Hwy 51 S
Arbor Vitae, WI 54568-9735
Phone (603) 627-1661

820 Crimson Ridge TRL
Fuquay Varina, NC 27526-2718
Phone (603) 627-1661

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.6 of 100Reported as group
Quality
62.55
Promoting interoperability
100
Improvement activities
40
Cost
76.03

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71074WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Aug 13, 2019 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 5, 2019 Accepting new patients
Flambeau Hospital Inc CurrentSince Jan 14, 2024 Accepting new patients
Southern New Hampshire Radiology Consultants PC Diagnostic Radiology CurrentSince Jun 17, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 5, 2019 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jan 14, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Memorial Hospital Inc CurrentSince Aug 25, 2020 Accepting new patients
Flambeau Hospital Inc CurrentSince Jan 14, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 5, 2019 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jan 14, 2024 Accepting new patients

Locations

11 Washington Pl
Bedford, NH 03110
Phone (603) 622-3670

703 Riverway Pl
Bedford, NH 03110
Phone (603) 668-7096

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

181 Corliss Ln
Colebrook, NH 03576
Phone (603) 237-8652

173 Middle St
Lancaster, NH 03584
Phone (603) 788-4911

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

9601 Townline Rd
Minocqua, WI 54548
Phone (715) 358-1000

9576 State Highway 70
Minocqua, WI 54548
Phone (715) 358-1000

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: jeremiah.libby@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 11

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1184045213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9576 HIGHWAY 70",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489067",
            "telephone_number": "715-358-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 38th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337101629",
            "country_code": "US",
            "telephone_number": "727-341-4819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "JEREMIAH",
        "middle_name": "J.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-16",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "71074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

Verify at the official NPI Registry.