Individual provider Active NPI

Paul Liebert

  • Orthopaedic Surgery Physician
  • Tomah, WI
National Provider Identifier
1689671869
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
48224 Issued in WI
Practice address
321 Butts Ave
Tomah, WI 54660-1412
Phone
(608) 372-2181
NPI assigned
Jul 5, 2005
Last updated
Jan 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 48224 WI Primary

Addresses

Primary practice location

321 Butts Ave
Tomah, WI 54660-1412

Mailing address

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 371-2181

Other practice location 1

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 371-2181

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pliebert10685@direct.monroeclinic.org Direct Tomah Memorial Hospital Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20050924000021 WI Practitioner - Orthopedic Surgery 1052369725 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Drexel University College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tomah Memorial Hospital IncGroup PAC ID 6901897016, shared by 4 NPIs, 54 clinicians

Practice addresses (Care Compare)

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48224WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomah Memorial Hospital Inc CurrentSince Nov 1, 2025 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Apr 1, 2013 Accepting new patients
Black River Health Inc CurrentSince Feb 1, 2025 Accepting new patients
Black River Health Inc CurrentSince Feb 1, 2025 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Jun 1, 2012 Accepting new patients
Richland Hospital CurrentSince Mar 1, 2025 Accepting new patients
Mile Bluff Medical Center Inc Current Accepting new patients
Richland Hospital Current Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Feb 1, 2012 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince Feb 1, 2012 Accepting new patients
Black River Health Inc Current Accepting new patients
Mile Bluff Medical Center Inc Orthopaedic Surgery CurrentSince Jun 1, 2012 Accepting new patients
Richland Hospital CurrentSince Mar 1, 2025 Accepting new patients
Tomah Memorial Hospital Inc Orthopaedic Surgery CurrentSince Apr 1, 2013 Accepting new patients

Locations

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

1050 Division St
Mauston, WI 53948
Phone (608) 847-6161

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

321 Butts Ave
Tomah, WI 54660
Phone (608) 372-2181

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888

Interoperability endpoints

  • Direct secure messaging: pliebert630874@direct.emplifyhealth.org

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1689671869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-371-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BUTTS AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601412",
            "telephone_number": "608-372-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Gopher Dr",
            "address_purpose": "LOCATION",
            "city": "Tomah",
            "state": "WI",
            "postal_code": "546604513",
            "country_code": "US",
            "telephone_number": "608-371-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERT",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "48224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pliebert10685@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "Tomah Memorial Hospital Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pliebert10685@direct.monroeclinic.org",
            "address_1": "501 Gopher Dr",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546604513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.