Individual provider Active NPI

Lily RKL Bastian, CNM

  • Advanced Practice Midwife
  • Burnsville, MN
National Provider Identifier
1104140029
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
488 Issued in MN
Practice address
201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone
(952) 892-2000
NPI assigned
Mar 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 1882 CA
Advanced Practice Midwife 367A00000X 488 MN Primary

Addresses

Primary practice location

201 E Nicollet Blvd
Burnsville, MN 55337-5714

Mailing address

277A Duncan St
San Francisco, CA 94131-2019
Phone (151) 071-7734

Other practice location 1

583 Summerfield Rd
Santa Rosa, CA 95405-5239
Phone (707) 539-1544

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213001534 MN Practitioner - Certified Nurse Midwife (CNM) 5496145187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

1875 Woodwinds Dr
Woodbury, MN 55125-2298
Phone (651) 232-6800

Merit-based Incentive Payment System (MIPS)

Final score
92.35 of 100Reported as group
Quality
91.74
Promoting interoperability
100
Improvement activities
40
Cost
77.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1882CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Nov 6, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 1, 2024 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Nov 6, 2021 Accepting new patients
Fairview Clinics CurrentSince Dec 1, 2021 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 1, 2024 Accepting new patients
Fairview Clinics CurrentSince Dec 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients

Locations

303 E Nicollet Blvd
Ste 160
Burnsville, MN 55337
Phone (952) 460-4000

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: lbastian695851@fairview.direct-ci.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1269216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1104140029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277A DUNCAN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941312019",
            "telephone_number": "151-071-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E NICOLLET BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553375714",
            "telephone_number": "952-892-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "583 Summerfield Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954055239",
            "country_code": "US",
            "telephone_number": "707-539-1544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASTIAN",
        "first_name": "LILY",
        "middle_name": "RKL",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-22",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1882",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

Verify at the official NPI Registry.