Active NPI
Micah Jon Nieboer, MD
- Orthopaedic Surgery Physician
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 68395
- Practice address
- 200 1St St SW
Rochester, MN 55905-2305 - Phone
- (507) 284-2511
- NPI assigned
- Apr 17, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 68395 | MN | Primary |
| Orthopaedic Surgery Physician | 207X00000X | 30229 | MN | |
| Orthopaedic Surgery Physician | 207X00000X | ME168209 | FL |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-2305
Mailing address
PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 284-2511
Other practice location 1
5901 E Fowler Ave Ste 100
Temple Terrace, FL 33617-2305
Phone (813) 978-9700
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mnieboer431698@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Loyola University of Chicago, Stritch School of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME168209 | FL | MD | Orthopaedic Surgery Physician |
| 30229 | MN | MD | Orthopaedic Surgery Physician |
| 68395 | MN | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tallahassee Orthopedic Clinic III, P.L. | Current | Accepting new patients | |
| Mayo Clinic | Orthopaedic Surgery | Current | Accepting new patients |
| Musculoskeletal Institute Chartered | Orthopaedic Surgery | Current | Accepting new patients |
| Mayo Clinic | Current | Accepting new patients | |
| Tallahassee Orthopedic Clinic III PL | Orthopaedic Surgery | Current | Accepting new patients |
| Tampa General Hospital | Current | Accepting new patients | |
| Musculoskeletal Institute Chartered | Orthopaedic Surgery | Current | Accepting new patients |
| Musculoskeletal Institute Chartered | Orthopaedic Surgery | Current | Accepting new patients |
Locations
3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808
909 N Dale Mabry Hwy
Fl Orthopaedic
Tampa, FL 33609
909 N Dale Mabry Hwy
Tampa, FL 33609
Phone (813) 287-9370
13060 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637
13020 N Telecom Pkwy
Temple Terrace, FL 33637
5901 E Fowler Ave
Ste 100
Temple Terrace, FL 33617
Phone (813) 987-9700
13020 N Telecom Pkwy
Fl Orthopaedic
Temple Terrace, FL 33637
2044 Trinity Oaks Blvd
Ste 110
Trinity, FL 34655
Phone (813) 978-7000
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Interoperability endpoints
- mnieboer431698@ehrdirect.mayoclinicmsg.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
- mnieboer257846@direct.tgh.org
Organizations & group practices 8
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.
-
- Orthopaedic Surgery Physician
- Temple Terrace, FL
- NPI 1386639920
-
- Medical Specialty Clinic/Center
- Tallahassee, FL
- NPI 1194778050
Orthopaedic Surgery
-
- Clinical Medical Laboratory
- Rochester, MN
- NPI 1083249577
-
- Orthopaedic Surgery Physician
- Zephyrhills, FL
- NPI 1467305839
-
- Orthopaedic Surgery Physician
- St Petersburg, FL
- NPI 1912626995
-
- Durable Medical Equipment & Medical Supplies
- Panama City Beach, FL
- NPI 1497617948
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rochester, MN
- NPI 1841266194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753833600000",
"number": "1336702224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860912",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860912",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559052305",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [
{
"address_1": "5901 E Fowler Ave Ste 100",
"address_purpose": "LOCATION",
"city": "Temple Terrace",
"state": "FL",
"postal_code": "336172305",
"country_code": "US",
"telephone_number": "813-978-9700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIEBOER",
"first_name": "MICAH",
"middle_name": "JON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-17",
"last_updated": "2025-07-30",
"certification_date": "2025-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "68395",
"primary": true
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "30229",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "ME168209",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mnieboer431698@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "200 1st St SW",
"city": "Rochester",
"state": "MN",
"country_code": "US",
"postal_code": "559052305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.