Buddy Wayne Lile, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

49329 Issued in MN

Practice address

550 Main Street
Suite 230
New Brighton, MN 55112

Phone

(612) 326-7558

Fax

(612) 454-2087

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Dr. Bud Wayne Ingram-Lile Other name

Medicare fee-for-service enrollment

Enrolled in MN, NM2 enrollments

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 2

Specialty

PsychiatryAlso: Addiction Medicine

Education

University of Texas Medical School at Houston, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blile340613@christushealth.direct-ci.net
• FHIR API: https://api.qualifacts.org/api/fhir/wmhcinc/r4/

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.

• St Vincent Hospital

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• Amherst H. Wilder Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1548337355
  Medicare reassignment NPD
• Hamm Memorial Psychiatric Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1609876051
  Medicare reassignment NPD
• Western Mental Health Center, Inc.

  • Mental Health Counselor
  • Marshall, MN
  • NPI 1982613311
  Medicare reassignment NPD
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  NPD
• St. Vincent Hospital

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1245438647
  NPD
• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104858612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN STREET",
            "address_2": "SUITE 230",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "612-326-7558",
            "fax_number": "612-454-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAIN STREET",
            "address_2": "SUITE 230",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "612-326-7558",
            "fax_number": "612-454-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILE",
        "first_name": "BUDDY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0010705",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "49329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VERMONT STATE LICENSE",
            "identifier": "042-0010705",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010386",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010386",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BUD",
            "last_name": "INGRAM-LILE",
            "middle_name": "WAYNE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebecca Levinski, MT-BC
• Tenzin Lhamo, NP
• Jason Ting Li, PH.D., L.P.
• Wendy Li
• Lifewell Health LLC
• Tucker Lindberg, MSN, APNP, PMHNP-BC
• Jordan Lindh, PSY.D.
• Lionheart Building & Consultants LLC
• Daniel Joel Lippert, LADC
• Living Spirit Therapy Services, LLC

• Psychiatry Physician in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.