Individual provider Active NPI

Anthony N Lackey, P.A.

  • Physician Assistant
  • Marquette, MI
National Provider Identifier
1295718898
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003024 Issued in MI
Practice address
420 W Magnetic St
Suite ER
Marquette, MI 49855-2711
Phone
(888) 674-0854
Fax
(906) 225-3370
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601003024 MI Primary

Addresses

Primary practice location

420 W Magnetic St
Suite ER
Marquette, MI 49855-2711

Mailing address

PO Box 220
Marquette, MI 49855-0220
Phone (888) 674-0854

Other identifiers 1

IdentifierTypeStateIssuer
5601003024OtherMIMICHIGAN LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050701000211 MI Practitioner - Physician Assistant 7012953896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, 116 clinicians
Bell Physician Practices IncGroup PAC ID 4981833654, 23 clinicians

Practice addresses (Care Compare)

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

901 Lakeshore Dr
Ishpeming, MI 49849-1367
Phone (906) 485-2687

Hospital & facility affiliations

  • Bell Hospital Hospital, Ishpeming, MI, CCN 231321
  • Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003024MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bell Physician Practices Inc CurrentSince Dec 1, 2013 Accepting new patients
Acquisition Bell Hospital LLC Past Accepting new patients
Bell Medical Center PastSince Apr 30, 2013 Accepting new patients

Locations

901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653

Organizations & group practices 11

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 2

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": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295718898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498550220",
            "telephone_number": "888-674-0854",
            "fax_number": "906-225-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W MAGNETIC ST",
            "address_2": "SUITE ER",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552711",
            "telephone_number": "888-674-0854",
            "fax_number": "906-225-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACKEY",
        "first_name": "ANTHONY",
        "middle_name": "N",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE NUMBER",
            "identifier": "5601003024",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.