Lyle E Lundblad, DO

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

35744 Issued in MN

Practice address

6600 France Avenue South
Suite 660
Edina, MN 55435

Phone

(952) 922-2000

Fax

(952) 920-7759

NPI assigned

Nov 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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.

• Midwest Institute of Urology

  • Specialist
  • Edina, MN
  • NPI 1750555314
  Authorized official Same address or phone

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396819322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVENUE SOUTH",
            "address_2": "SUITE 660",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-922-2000",
            "fax_number": "952-920-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVENUE SOUTH",
            "address_2": "SUITE 660",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-922-2000",
            "fax_number": "952-920-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDBLAD",
        "first_name": "LYLE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "35744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02T31LU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie M Luna, PT
• Lund Food Holdings, Inc.
• Amanda Marie Lund, OT
• Todd Adrian Lunda, MS
• Heather Colleen Lundberg, ACNS-BC
• Tara Lunde, LGSW
• Max Joseph Miller Lundeen, PA-C
• Brianna Lundgren
• Alyssa Lundquist, PT
• Lundquist, PA

• Urology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Urology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.