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Individual provider Active NPI

Mats Lars Liden, MD

  • Diagnostic Radiology Physician
  • Sartell, MN
National Provider Identifier
1457514341
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
55109 Issued in MN
Practice address
166 19TH Street South
Suite 100
Sartell, MN 56377-2154
Phone
(320) 251-0609
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5748 NE
Diagnostic Radiology Physician 2085R0202X 55109 MN Primary

Addresses

Primary practice location

166 19TH Street South
Suite 100
Sartell, MN 56377-2154

Mailing address

PO Box 1450 NW 6035
Minneapolis, MN 55485-6035
Phone (952) 542-8553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20120913000021 MN Practitioner - Diagnostic Radiology 1254508443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Dakota School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians

Practice addresses (Care Compare)

5775 Wayzata Blvd
Suite 190
St Louis Park, MN 55416-2627
Phone (952) 541-1840

Hospital & facility affiliations

  • Alomere Health Hospital, Alexandria, MN, CCN 240030
  • Glacial Ridge Hospital Hospital, Glenwood, MN, CCN 241376
  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036
  • Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55109MNMDDiagnostic Radiology Physician
5748NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Aug 1, 2012 Accepting new patients
Cdi Twin Cities ASC LLC Current Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology Current Accepting new patients

Locations

964 S Orlando Ave
Winter Park, FL 32789
Phone (407) 628-5051

11900 Pennsylvania St
Ste 100
Carmel, IN 46032

111 17th Ave E
Alexandria, MN 56308
Phone (320) 762-1511

166 19th St S
Ste 100
Sartell, MN 56377

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

Organizations & group practices 7

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1457514341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450 NW 6035",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554856035",
            "telephone_number": "952-542-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 19TH STREET SOUTH",
            "address_2": "SUITE 100",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772154",
            "telephone_number": "320-251-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDEN",
        "first_name": "MATS",
        "middle_name": "LARS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "5748",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "55109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.