NPIMap

Individual provider Active NPI

Roseller Libarnes, MD

  • Internal Medicine Physician
  • Fort Madison, IA
National Provider Identifier
1427028760
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35461 Issued in IA
Practice address
5409 Avenue O
Fort Madison, IA 52627-9601
Phone
(319) 376-2134
Fax
(319) 376-2188
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35461 IA Primary

Addresses

Primary practice location

5409 Avenue O
Fort Madison, IA 52627-9601

Mailing address

5409 Avenue O
Fort Madison, IA 52627-9601
Phone (319) 376-2134

Other identifiers 5

IdentifierTypeStateIssuer
07604OtherIABLUE CROSS WELLMARK
504472OtherIAIOWA HEALTH SOLUTIONS
0426536MedicaidIA
IA0136OtherIAJOHN DEERE HEALTH
P00081383OtherIARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000559 IA Practitioner - Internal Medicine 0345236360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 S Gear Ave
West Burlignton, IA 52655-1679
Phone (319) 768-1000

5409 Ave O
Fort Madison, IA 52627-9602

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35461IAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Iowa Regional Medical Center, Inc. CurrentSince Jul 1, 2021 Accepting new patients

Locations

5409 Avenue O
Ste 1
Fort Madison, IA 52627
Phone (319) 376-2134

5409 Avenue O
Ste 103
Fort Madison, IA 52627
Phone (319) 372-6280

5409 Avenue O
Fort Madison, IA 52627
Phone (319) 372-6530

5445 Avenue O
Fort Madison, IA 52627
Phone (319) 372-6530

1221 S Gear Ave
West Burlington, IA 52655
Phone (319) 768-3622

Organizations & group practices 1

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 5

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1427028760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 AVENUE O",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279601",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 AVENUE O",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279601",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBARNES",
        "first_name": "ROSELLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "35461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS WELLMARK",
            "identifier": "07604",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA HEALTH SOLUTIONS",
            "identifier": "504472",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0426536",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH",
            "identifier": "IA0136",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00081383",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Madison, IA

Sources for this page

Verify at the official NPI Registry.