Individual provider Active NPI

John D Liveringhouse, MD

  • Gastroenterology Physician
  • Woodbury, MN
National Provider Identifier
1902874829
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
45036 Issued in MN
Practice address
237 Radio Dr Ste 210
Woodbury, MN 55125-4478
Phone
(612) 871-1145
Fax
(612) 870-5491
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 4

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 17

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

View all 17

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Minnesota Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mngi Digestive Health PA 276 clinicians

Practice addresses (Care Compare)

1185 Town Centre Dr
Suite 200
Eagan, MN 55123-1343
Phone (612) 871-1145

15700 37TH Ave N
Plymouth, MN 55446-3399
Phone (612) 871-1145

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7000

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (612) 892-2121

2651 Hillcrest Dr
Suite 302
Hudson, WI 54016-9919
Phone (612) 871-1145

3001 Broadway St NE
Suite 500
Minneapolis, MN 55413-2197
Phone (612) 871-1145

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5200

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

3588 Arcade St
Suite 110
Vadnais Heights, MN 55127-7135
Phone (612) 871-1145

9145 Springbrook Dr NW
Suite 300
Coon Rapids, MN 55433-5897
Phone (612) 871-1145

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy63
Upper gastrointestinal (GI) endoscopy for acid reflux103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060602000222 MN Practitioner - GastroenterologyPractitioner - Internal Medicine 5890760037 Reassigns benefits to 1 organization
I20231004002956 WI Practitioner - Gastroenterology 5890760037 Reassigns benefits to 1 organization

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
All Homecaring Minnesota, Inc.Columbia Heights, MN, CCN 247113 Home health agency 5% Or Greater Direct Ownership Interest (15%)
Corporate Director
Jan 1, 2022
Jan 1, 2022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45036MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mngi Digestive Health, P.a. Gastroenterology CurrentSince Apr 3, 2018 Accepting new patients
Centracare Clinic Past Accepting new patients
Gastroenterology Consultants of Augusta, PC Past Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

9855 Hospital Dr
Ste 102B
Maple Grove, MN 55369
Phone (763) 581-5600

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

237 Radio Dr
Ste 210
Woodbury, MN 55125
Phone (612) 502-5092

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

Interoperability endpoints

  • Direct secure messaging: john.liveringhousemd.p1@direct.mngastro.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/15547/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 45036 MN Primary

Addresses

NPPES NPI Registry

Primary practice location

237 Radio Dr Ste 210
Woodbury, MN 55125-4478

Mailing address

PO Box 14909
Minneapolis, MN 55414-0909
Phone (612) 871-1145

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 19, 2023.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1902874829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 RADIO DR STE 210",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254478",
            "telephone_number": "612-871-1145",
            "fax_number": "612-870-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERINGHOUSE",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "45036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.