Individual provider Active NPI

Lydia W NG, M.D.

  • Radiation Oncology Physician
  • Rochester, MN
National Provider Identifier
1174879076
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
62447 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-5000
Phone
(507) 284-2511
NPI assigned
Jul 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 251838 MA
Radiation Oncology Physician 2085R0001X A129905 CA
Radiation Oncology Physician 2085R0001X 62447 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-5000

Mailing address

200 1St Street SW
Rochester, MN 55905
Phone (507) 284-2511

Other practice location 1

1100 N State St
Los Angeles, CA 90033-5000
Phone (323) 409-5019

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lng109326@ehrdirect.mayoclinicmsg.org

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
I20170727000133 MN Practitioner - Radiation Oncology 9537439393 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Harvard Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251838MAMDInternal Medicine Physician
A129905CAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 14, 2017 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Aug 15, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Aug 14, 2017 Accepting new patients
Mayo Clinic CurrentSince Aug 15, 2017 Accepting new patients
Mayo Clinic CurrentSince Aug 15, 2017 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Aug 15, 2017 Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1821 North Ave
Northfield, MN 55057
Phone (507) 293-1100

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1174879076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST STREET SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559055000",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N State St",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335000",
            "country_code": "US",
            "telephone_number": "323-409-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "LYDIA",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-28",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "251838",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A129905",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MN",
            "license": "62447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lng109326@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559055000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.