NPIMap

Individual provider Active NPI

Joshua Ernest Lackner, MD

  • Internal Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1033499306
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57429 Issued in MN
Practice address
2120 Ford Pkwy
Saint Paul, MN 55116-1863
Phone
(651) 241-9600
NPI assigned
Aug 18, 2011
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 107265 MN
Internal Medicine Physician 207R00000X 57429 MN Primary

Addresses

Primary practice location

2120 Ford Pkwy
Saint Paul, MN 55116-1863

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlackner588215@excellian.direct.allina.com Direct

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
I20141111002408 MN Practitioner - Internal Medicine 6002038817 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc Current Accepting new patients
West Side Community Health Services, Inc. CurrentSince Jan 11, 2014 Accepting new patients
Allina Health System Current Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Oct 17, 2016 Accepting new patients
West Side Community Health Services, Inc. CurrentSince Jan 11, 2014 Accepting new patients
Allina Health System Current Accepting new patients
Hennepin Healthcare System Inc CurrentSince Oct 17, 2016 Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
West Side Community Health Services, Inc. Current Accepting new patients
Allina Health System CurrentSince Sep 26, 2022 Accepting new patients
Allina Health System CurrentSince Sep 26, 2022 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2120 Ford Pkwy
Saint Paul, MN 55116
Phone (651) 241-9600

153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816

Interoperability endpoints

  • Direct secure messaging: jlackner588215@excellian.direct.allina.com

Organizations & group practices 12

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.

Hospital & facility affiliations 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1033499306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161863",
            "telephone_number": "651-241-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKNER",
        "first_name": "JOSHUA",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-18",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "107265",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "57429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlackner588215@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2120 Ford Pkwy",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551161863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.