Individual provider Active NPI

Ernest William Lampe, M.D.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Minneapolis, MN
National Provider Identifier
1023062783
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
19808 Issued in MN
Practice address
3329 University Avenue SE
Minneapolis, MN 55414
Phone
(612) 454-2260
Fax
(612) 454-2340
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 19808 MN
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 19808 MN Primary

Addresses

Primary practice location

3329 University Avenue SE
Minneapolis, MN 55414

Mailing address

550 Main Street
Suite 190
New Brighton, MN 55112
Phone (612) 326-7600

Other identifiers 1

IdentifierTypeStateIssuer
442080200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20050303000266 MN Practitioner - Addiction MedicinePractitioner - General Surgery 1951213370

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19808MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
C10202017363071 Past Accepting new patients
MBH-MN Medical Clinic PA Past Accepting new patients
Avalon Programs, LLC Past Accepting new patients
Avalon Programs, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1023062783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN STREET",
            "address_2": "SUITE 190",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "612-326-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 UNIVERSITY AVENUE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "612-454-2260",
            "fax_number": "612-454-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPE",
        "first_name": "ERNEST",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "19808",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MN",
            "license": "19808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "442080200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.