Joseph William Lackner, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15633 Issued in MN

Practice address

1601 Golf Course Rd
Grand Rapids, MN 55744-8648

Phone

(218) 326-3401

NPI assigned

Dec 13, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  • Community/Retail Pharmacy
  • Grand Rapids, MN
  • NPI 1225441157
  NPD

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

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1765584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765584000000",
    "number": "1073477089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 3RD ST S",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GOLF COURSE RD",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557448648",
            "telephone_number": "218-326-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKNER",
        "first_name": "JOSEPH",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-13",
        "last_updated": "2025-12-13",
        "certification_date": "2025-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "15633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Kreklow, DDS
• Natalie Kay Kruse, NP
• Andrew Stuart Kuehn, DDS
• Erika M Kuehn, D.O.
• Matthew Kustritz
• Steven F. Lader, DO
• Lakeside Psychological Services
• Lakeview Behavioral Health Inc.
• Lakeview Behavioral Health LLC
• Lauren Richard Lampi, D. D. S.

• Physician Assistant in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.