Individual provider Active NPI

Katrina Nesta Glazebrook, MBCHB

  • Diagnostic Radiology Physician
  • Rochester, MN
National Provider Identifier
1437124872
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
41892 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 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 41892 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
752670900MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kglazebrook28430@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
I20100317000246 MN Practitioner - Diagnostic Radiology 8527193481 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1985
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)

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41892MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 12, 2018 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jul 12, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Sep 25, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Sep 25, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Sep 25, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic CurrentSince Mar 1, 2000 Accepting new patients
Mayo Clinic CurrentSince Mar 1, 2000 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Sep 25, 2018 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-St James CurrentSince Jul 12, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 12, 2018 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Jul 12, 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

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

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 18

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 18

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1437124872",
    "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": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZEBROOK",
        "first_name": "KATRINA",
        "middle_name": "NESTA",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "41892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "752670900",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kglazebrook28430@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.