NPIMap

Individual provider Active NPI

Lissa N Chipeco, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Saint Paul, MN
National Provider Identifier
1265529663
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
43877 Issued in MN
Practice address
2500 Como Ave
Saint Paul, MN 55108-1460
Phone
(651) 641-6200
Fax
(651) 641-6295
NPI assigned
Oct 6, 2006
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 43877 MN Primary

Addresses

Primary practice location

2500 Como Ave
Saint Paul, MN 55108-1460

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other identifiers 1

IdentifierTypeStateIssuer
028720200MedicaidMN

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
I20061130000291 MN Practitioner - Family PracticePractitioner - Geriatric Medicine 3274531272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1654 Diffley Rd
Suite 100
Eagan, MN 55122-2237
Phone (651) 641-3900

205 Wabasha Ave S
Saint Paul, MN 55107-1805

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Dec 1, 2006 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Dec 1, 2006 Accepting new patients
Presbyterian Homes of North Oaks Inc, Past Accepting new patients
Group Health, Inc. Past Accepting new patients
Group Health Plan, Inc Past Accepting new patients
Villas at St Paul LLC Past Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

510 2nd St SE
Pine City, MN 55063
Phone (320) 629-6721

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

401 Phalen Blvd
#41103F
Saint Paul, MN 55130
Phone (651) 254-7600

Interoperability endpoints

  • Direct secure messaging: lchipeco41564@direct.healthpartners.com

Organizations & group practices 7

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1265529663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-641-6200",
            "fax_number": "651-641-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPECO",
        "first_name": "LISSA",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MN",
            "license": "43877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028720200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.