Individual provider Active NPI

Carly Leah Lodewyks

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Minneapolis, MN
National Provider Identifier
1295400471
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
72165 Issued in MN
Practice address
800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723
Phone
(612) 863-3900
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 72165 MN Primary

Addresses

Primary practice location

800 E 28TH St Ste H2100
Minneapolis, MN 55407-3723

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

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
I20220830003021 MN Practitioner - Cardiac Surgery 3072919059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
University of Manitoba, Faculty of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-4762

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Sep 19, 2022 Accepting new patients
Minneapolis Heart Institute at Ridgeview Heart Center, LLC CurrentSince Sep 19, 2022 Accepting new patients
Allina Health System CurrentSince Sep 19, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

13205 Isle Dr
#100
Baxter, MN 56425
Phone (218) 855-5280

111 Hundertmark Rd
Ste 303N
Chaska, MN 55318
Phone (952) 442-7843

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

800 E 28th St
Ste H2100
Minneapolis, MN 55407
Phone (612) 863-3900

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461

Interoperability endpoints

  • Direct secure messaging: clodewyks587212@excellian.direct.allina.com

Organizations & group practices 6

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1295400471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST STE H2100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODEWYKS",
        "first_name": "CARLY",
        "middle_name": "LEAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MN",
            "license": "72165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.