Nicholas Lange, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

65880 Issued in MN

Practice address

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905

Phone

(651) 292-0000

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, MN, WI, ND4 enrollments

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 4

Specialty

Diagnostic Radiology

Education

New York University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Pembina County Memorial Hospital AssociationGroup PAC ID 4789643719, 142 clinicians

Altru Health SystemGroup PAC ID 1355251604, 675 clinicians

Lutheran Charity AssociationGroup PAC ID 2264341031, 168 clinicians

Marshfield Clinic IncGroup PAC ID 2264345206, 207 clinicians

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Midwest Radiology Outpatient Imaging LLCGroup PAC ID 3870495591, 133 clinicians

St. Joseph'S Hospital and Health CenterGroup PAC ID 0547177560, 157 clinicians

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Range Regional Health ServicesGroup PAC ID 8022920024, 349 clinicians

Madison Healthcare ServicesGroup PAC ID 9638080187, 29 clinicians

Suburban Imaging LLCGroup PAC ID 4688564867, 142 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regions Hospital Hospital, Saint Paul, MN, CCN 240106
• Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
• Amery Hospital & Clinic Hospital, Amery, WI, CCN 521308
• Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345
• St Croix Regional Medical Center Hospital, Saint Croix Falls, WI, CCN 521337

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 50)

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.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218

  MN

  Medicare reassignment Care Compare group NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606

  MN

  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631

  MN

  Medicare reassignment Care Compare group NPD
• Madison Healthcare Services

  • Critical Access Hospital
  • Madison, MN
  • NPI 1942246848

  MN

  Medicare reassignment Care Compare group NPD
• Midwest Radiology Outpatient Imaging, LLC

  • Diagnostic Radiology Physician
  • Saint Paul, MN
  • NPI 1720059264

  Diagnostic Radiology, MN

  Medicare reassignment Care Compare group NPD
• Midwest Radiology, PA

  • Diagnostic Radiology Physician
  • Roseville, MN
  • NPI 1952307175

  Diagnostic Radiology, MN, WI

  Medicare reassignment Care Compare group NPD
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265

  MN

  Medicare reassignment Care Compare group NPD
• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429

  MN

  Medicare reassignment Care Compare group NPD
• Suburban Imaging, LLC

  • Radiology Clinic/Center
  • Roseville, MN
  • NPI 1427008937

  MN

  Medicare reassignment Care Compare group NPD
• The Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638

  MN

  Medicare reassignment Care Compare group NPD
• Altru Health System

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1043309552

  MN

  Medicare reassignment Care Compare group NPD
• Lutheran Charity Association

  • Diagnostic Radiology Physician
  • Jamestown, ND
  • NPI 1700038981

  Diagnostic Radiology, MN

  Medicare reassignment Care Compare group NPD

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

• Lakeview Memorial Hospital Association Inc

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1538138003

  Hospital

  Care Compare affiliation
• Lakeview Memorial Hospital Association Inc

  • Land Ambulance
  • Stillwater, MN
  • NPI 1730213653

  Hospital

  Care Compare affiliation
• Regions Hospital

  • Pharmacy
  • Saint Paul, MN
  • NPI 1013951748

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105

  Hospital

  Care Compare affiliation
• Regions Hospital

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1134157092

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1306873872

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1629006457

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1679391122

  Hospital

  Care Compare affiliation
• Regions Hospital

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1871929976

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1962149419

  Hospital

  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  • Critical Access Hospital
  • Amery, WI
  • NPI 1093763518

  Hospital

  Care Compare affiliation
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Clear Lake, WI
  • NPI 1366878449

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1285650952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Thompson St.",
            "address_purpose": "LOCATION",
            "city": "St. Paul",
            "state": "MN",
            "postal_code": "55102",
            "country_code": "US",
            "telephone_number": "651-292-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGE",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101239993",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "65880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Lake, M.A., LMFT
• Katherine Hailey Lake, OTR/L
• David P Lambert, MD
• Elizabeth Lanari, LMFT
• Harlie Lane
• Katelyn M Langlie, PA-C
• Alan Laorr, M.D.
• Jennifer Laroy, M.D.
• Jared Michael Larsen, D.C.
• Josh Larson

• All providers in Roseville, MN
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.