NPIMap

Individual provider Active NPI

Evan Lucas Dyce, CNP

  • Family Nurse Practitioner
  • Monticello, MN
National Provider Identifier
1013437110
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5196 Issued in MN
Practice address
1107 Hart Blvd
Monticello, MN 55362-8538
Phone
(763) 271-2200
Fax
(763) 271-1799
NPI assigned
Jun 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5196 MN Primary

Addresses

Primary practice location

1107 Hart Blvd
Monticello, MN 55362-8538

Mailing address

2012 Chardonnay LN NW
Rochester, MN 55901-1901
Phone (507) 828-6318

Other practice location 1

1414 S Oak Ave Ste 6A
Owatonna, MN 55060-3957
Phone (507) 413-8050

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
I20170921000115 MN Practitioner - Nurse Practitioner 8022382654 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians

Practice addresses (Care Compare)

16830 198TH Ave NW
Centracare Clinic Big Lake
Big Lake, MN 55309-4860
Phone (763) 263-7300

Hospital & facility affiliations

  • Centracare Health - Monticello Hospital, Monticello, MN, CCN 241362
  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Oct 1, 2017 Accepting new patients
Centracare Clinic CurrentSince Aug 3, 2020 Accepting new patients
Centracare Health System-NR LLC CurrentSince Oct 1, 2017 Accepting new patients
Centracare Clinic CurrentSince Aug 3, 2020 Accepting new patients

Locations

12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000

16830 198th Ave NW
Big Lake, MN 55309
Phone (763) 263-7300

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

1107 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2200

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

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

Interoperability endpoints

  • Direct secure messaging: edyce376568@direct.centracare.com

Organizations & group practices 6

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 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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013437110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 CHARDONNAY LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011901",
            "telephone_number": "507-828-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628538",
            "telephone_number": "763-271-2200",
            "fax_number": "763-271-1799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 S Oak Ave Ste 6A",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "550603957",
            "country_code": "US",
            "telephone_number": "507-413-8050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYCE",
        "first_name": "EVAN",
        "middle_name": "LUCAS",
        "name_prefix": "Dr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "5196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.