Individual provider Active NPI

Lindy Thaker, MD

  • Pediatrics Physician
  • Saint Paul, MN
National Provider Identifier
1174670038
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD456456 Issued in DC
Practice address
1983 Sloan PL Ste 1
Saint Paul, MN 55117-2095
Phone
(651) 326-5700
NPI assigned
Jan 4, 2007
Last updated
Apr 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD442767 PA
Pediatrics Physician 208000000X MD43493 TN
Pediatrics Physician 208000000X MD456456 DC Primary
Physician Nutrition Specialist (Pediatrics) 2080P1004X 65308 MN

Addresses

Primary practice location

1983 Sloan PL Ste 1
Saint Paul, MN 55117-2095

Mailing address

1983 Sloan PL Ste 1
Saint Paul, MN 55117-2095

Other identifiers 2

IdentifierTypeStateIssuer
65308OtherMNMINNESOTA MEDICAL LICENSE
MD456456OtherDCDC MEDICAL LICENSE

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
I20250627001495 MN Practitioner - Pediatric Medicine 9032367644 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD456456DCMDPediatrics Physician
MD442767PAMDPediatrics Physician
65308MNMDMedical license number

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2025 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jun 1, 2025 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Children's Hospital Past Accepting new patients

Locations

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1983 Sloan Pl
Ste 1
Saint Paul, MN 55117
Phone (651) 326-5700

Interoperability endpoints

  • Direct secure messaging: lthaker2675664@fairview.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1174670038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 SLOAN PL STE 1",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1983 SLOAN PL STE 1",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172095",
            "telephone_number": "651-326-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKER",
        "first_name": "LINDY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD442767",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD43493",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD456456",
            "primary": true
        },
        {
            "code": "2080P1004X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Physician Nutrition Specialist",
            "state": "MN",
            "license": "65308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA MEDICAL LICENSE",
            "identifier": "65308",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC MEDICAL LICENSE",
            "identifier": "MD456456",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.