Charles Lick, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

31933 Issued in MN

Practice address

303 Catlin St
Buffalo Hospital
Buffalo, MN 55313

Phone

(763) 684-7500

Fax

(763) 684-7152

NPI assigned

Mar 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Emergency Medicine

Education

University of Minnesota Medical School, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment Care Compare group NPD
• Emergency Physicians Professional Association

  • Emergency Medicine Physician
  • Bloomington, MN
  • NPI 1801871934
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • Eagan, MN
  • NPI 1780980599
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Emergency Physicians Professional Association

  • Urgent Care Clinic/Center
  • Golden Valley, MN
  • NPI 1750188488
  NPD
• Emergency Physicians Professional Association

  • Urgent Care Clinic/Center
  • Woodbury, MN
  • NPI 1972734721
  NPD
• Allina Health System

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1467758813
  NPD (past)

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1366419525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 FELTL RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553437983",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CATLIN ST",
            "address_2": "BUFFALO HOSPITAL",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "55313",
            "telephone_number": "763-684-7500",
            "fax_number": "763-684-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICK",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "31933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "31933",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "832590100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Lawrence, MD
• Anne-Marie Lee, MD
• Julie Lee, PHARMD
• Brenda Kay Lenz, PHD, APRN, FNP-C
• Kevin Paul Lenz, MSPT
• Thomas W Liester, P.A.-C.
• Cassandra Loeffler, D.C.
• Kristina A Loken, MD
• Cheryl Ann Louise Longrie, LPCC
• Maudie Rae Louisiana, D.C.

• Emergency Medicine Physician in Buffalo, MN
• Providers in Buffalo, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.