NPIMap

Individual provider Active NPI

Tyler Lacey, M.D.

  • Family Medicine Physician
  • Fergus Falls, MN
National Provider Identifier
1255866877
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
64592 Issued in MN
Practice address
111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone
(218) 739-2221
NPI assigned
Apr 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 64592 MN Primary

Addresses

Primary practice location

111 W Vernon Ave
Fergus Falls, MN 56537-2741

Mailing address

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200924002824 MN Practitioner - Family Practice 2961735360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prairie Ridge Hospital and Health ServicesGroup PAC ID 0648222349, 90 clinicians

Practice addresses (Care Compare)

111 W Vernon Ave
Fergus Falls, MN 56537-2741
Phone (218) 739-2221

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

Hospital & facility affiliations

  • Vivie Home Health Home health agency, Alexandria, MN, CCN 248096
  • Aveanna Home Health Home health agency, Waite Park, MN, CCN 247185
  • New Dimensions Home Health Care Inc. Home health agency, Fergus Falls, MN, CCN 248038
  • Vivie Hospice Hospice, Alexandria, MN, CCN 241592
  • Prairie Ridge Hospital and Health Services Hospital, Elbow Lake, MN, CCN 241379
  • Lake Region Healthcare Corporation Hospital, Fergus Falls, MN, CCN 240052
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
  • Pioneer Care Center Nursing home, Fergus Falls, MN, CCN 245463
  • West Wind Village Nursing home, Morris, MN, CCN 245262
  • LB Broen Home Nursing home, Fergus Falls, MN, CCN 245453

Merit-based Incentive Payment System (MIPS)

Final score
89.33 of 100Reported as group
Quality
93.68
Promoting interoperability
100
Improvement activities
40
Cost
70.75

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64592MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Sep 12, 2024 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Sep 12, 2024 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Aug 1, 2020 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Aug 1, 2020 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Jan 25, 2026 Accepting new patients
Pioneer Home Incorporated Past Accepting new patients
Lutheran Brethren Retirement Services Inc Past Accepting new patients
West Central Internal Medicine Past Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

111 W Vernon Ave
Fergus Falls, MN 56537
Phone (218) 736-5770

712 S Cascade St
Fergus Falls, MN 56537

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
PioneercareFergus Falls, MN, CCN 245463 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Nov 1, 2024
Nov 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1255866877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S CASCADE ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372913",
            "telephone_number": "218-736-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372741",
            "telephone_number": "218-739-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEY",
        "first_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "64592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

Verify at the official NPI Registry.