Individual provider Active NPI

Greta Beth Liebo, MD

  • Diagnostic Radiology Physician
  • Rochester, MN
National Provider Identifier
1417184326
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
55596 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Jun 18, 2009
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 55596 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

701 Park Ave
HCMC - Office of the Medical Director
Minneapolis, MN 55415-1623
Phone (612) 873-3922

Other practice location 2

701 Park Ave
HCMC - Office of the Medical Director
Minneapolis, MN 55415-1623
Phone (612) 873-3922

Other names 1

  • Greta Liebo Del Prado Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gliebo152443@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140910000085 MN Practitioner - Diagnostic Radiology 1254550072 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

1216 2ND St SW
Rochester, MN 55902-1906
Phone (507) 255-5123

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

201 W Ctr St
Rochester, MN 55902-3003
Phone (507) 255-5123

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2014 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2014 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Nov 28, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Nov 28, 2018 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

825 Mankato Ave
Winona, MN 55987
Phone (507) 454-4925

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1417184326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "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": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_2": "HCMC - Office of the Medical Director",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Park Ave",
            "address_2": "HCMC - Office of the Medical Director",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBO",
        "first_name": "GRETA",
        "middle_name": "BETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "55596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gliebo152443@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GRETA",
            "last_name": "DEL PRADO",
            "middle_name": "LIEBO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.