NPIMap

Individual provider Active NPI

Nicole Lyons

  • Surgery Physician
  • Saint Paul, MN
National Provider Identifier
1013336106
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
62252 Issued in MN
Practice address
640 Jackson St
Saint Paul, MN 55101-2502
Phone
(651) 254-5151
Fax
(651) 254-3123
NPI assigned
Apr 16, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Neurological Surgery Physician 207T00000X 62252 MN
Surgery Physician 208600000X 62252 MN Primary

Addresses

Primary practice location

640 Jackson St
Saint Paul, MN 55101-2502

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516
Phone (651) 254-5151

Other practice location 1

701 Park Avenue,
Mail Code P-5
Minneapolis, MN 55415
Phone (612) 873-2849

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
I20190731001185 MN Practitioner - General Surgery 0143525303 Reassigns benefits to 14 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Minnesota Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

1200 6TH Ave N
Centracare Clic River Campus
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62252MNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Health System - Long Prairie CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Sep 1, 2019 Accepting new patients
Cura of Sauk Centre LLC CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System-NR LLC CurrentSince Jan 1, 2020 Accepting new patients
Unity Family Healthcare CurrentSince Jan 28, 2023 Accepting new patients
Centracare Clinic CurrentSince Sep 1, 2019 Accepting new patients
St. Cloud Hospital CurrentSince Mar 18, 2020 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System - Long Prairie CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Health-Paynesville LLC Current Accepting new patients
Centracare Health-Paynesville LLC CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System - Melrose CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System - Melrose CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Unity Family Healthcare Current Accepting new patients
Centracare Clinic CurrentSince Sep 1, 2019 Accepting new patients
Centracare Health System-NR LLC CurrentSince Jan 1, 2020 Accepting new patients
St. Cloud Hospital CurrentSince Mar 18, 2020 Accepting new patients
Unity Family Healthcare CurrentSince Jan 28, 2023 Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
Cura of Long Prairie LLC Past Accepting new patients

Locations

7892 Solutions Ctr
Chicago, IL 60677

1108 1st St SE
Little Falls, MN 56345
Phone (320) 632-3671

811 2nd St SE
Little Falls, MN 56345
Phone (320) 631-7000

815 2nd St SE
Little Falls, MN 56345
Phone (320) 632-5441

50 Centracare Dr
Long Prairie, MN 56347
Phone (320) 732-2131

525 Main St W
Melrose, MN 56352
Phone (320) 256-4228

701 Park Ave
#P5
Minneapolis, MN 55415
Phone (612) 873-2300

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Interoperability endpoints

  • Direct secure messaging: nlyons472320@direct.centracare.com

Organizations & group practices 26

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 26

Hospital & facility affiliations 8

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1013336106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-5151",
            "fax_number": "651-254-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-5151",
            "fax_number": "651-254-3123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Avenue,",
            "address_2": "Mail Code P-5",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55415",
            "country_code": "US",
            "telephone_number": "612-873-2849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYONS",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "62252",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "62252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.