Individual provider Active NPI

Christopher Thomas Lucido, MD/PHD

  • Dermatology Physician
  • Edina, MN
National Provider Identifier
1205416906
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
79966 Issued in MN
Practice address
3316 W 66TH St
Edina, MN 55435-2532
Phone
(952) 920-3808
Fax
(952) 920-8899
NPI assigned
Apr 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 79966 MN Primary

Addresses

Primary practice location

3316 W 66TH St
Edina, MN 55435-2532

Mailing address

3316 W 66TH St
Edina, MN 55435-2532
Phone (952) 920-3808

Other practice location 1

420 Delaware Street SE, MMC 98
Minneapolis, MN 55455
Phone (612) 624-9964

Other practice location 2

1400 W 22nd St
Sioux Falls, SD 57105-1554
Phone (605) 357-1380

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
I20250903002559 MN Practitioner - Dermatology 4880099506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Sanford School of Medicine of University of South Dakota, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists, PAGroup PAC ID 1456248137, 18 clinicians

Practice addresses (Care Compare)

3316 W 66TH St
Edina, MN 55435-2544
Phone (952) 920-3808

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions143
Removal or shaving of skin growth33
Skin biopsy64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79966MNMDDermatology Physician
0605SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Specialists, PA Dermatology CurrentSince Sep 15, 2025 Accepting new patients

Locations

3316 W 66th St
Ste 120
Edina, MN 55435

3316 W 66th St
Edina, MN 55435
Phone (952) 920-3808

3316 W 66th St
Ste 200
Minneapolis, MN 55435
Phone (612) 920-3808

Interoperability endpoints

  • Direct secure messaging: clucido@directaddress.net

Organizations & group practices 1

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 3

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1205416906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 W 66TH ST",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352532",
            "telephone_number": "952-920-3808",
            "fax_number": "952-920-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 W 66TH ST",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352532",
            "telephone_number": "952-920-3808",
            "fax_number": "952-920-8899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Delaware Street SE, MMC 98",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55455",
            "country_code": "US",
            "telephone_number": "612-624-9964",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051554",
            "country_code": "US",
            "telephone_number": "605-357-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCIDO",
        "first_name": "CHRISTOPHER",
        "middle_name": "THOMAS",
        "credential": "MD/PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "79966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.