Individual provider Active NPI

Jill Nicole Lyle, CNP

  • Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1376788968
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP27 Issued in MN
Practice address
2833 Chicago Ave
Minneapolis, MN 55407-1319
Phone
(612) 863-3333
Fax
(763) 577-7800
NPI assigned
Dec 10, 2008
Last updated
Aug 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP27 MN Primary

Addresses

Primary practice location

2833 Chicago Ave
Minneapolis, MN 55407-1319

Mailing address

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

Other names 1

  • Jill Nicole Baertsch Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlyle45828@excellian.direct.allina.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090305000736 MN Practitioner - Nurse Practitioner 2961568555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key CorporationGroup PAC ID 9032009238, 53 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1394 Jackson St
Suite 201
Saint Paul, MN 55117-4630
Phone (612) 315-5866

2833 Chicago Ave
Minneapolis, MN 55407-1319
Phone (612) 863-3333

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP27MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 1, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Dec 1, 2008 Accepting new patients
Allina Health System CurrentSince May 1, 2023 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

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

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

2833 Chicago Ave
Minneapolis, MN 55407
Phone (612) 863-3333

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

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

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

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7580

Interoperability endpoints

  • Direct secure messaging: jlyle45828@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1376788968",
    "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": "2833 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071319",
            "telephone_number": "612-863-3333",
            "fax_number": "763-577-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLE",
        "first_name": "JILL",
        "middle_name": "NICOLE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "CNP27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlyle45828@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2833 Chicago Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554071319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "BAERTSCH",
            "middle_name": "NICOLE",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.