Individual provider Active NPI

Lyn Tangen, M.D.

  • Colon & Rectal Surgery Physician
  • Urbana, IL
National Provider Identifier
1417068131
Registry record updated May 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
036073498 Issued in IL
Practice address
611 W. Park St.
Colon & Rectal Surgery
Urbana, IL 61801-2500
Phone
(217) 383-3080
Fax
(217) 383-4868
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 036073498 IL Primary

Addresses

Primary practice location

611 W. Park St.
Colon & Rectal Surgery
Urbana, IL 61801-2500

Mailing address

611 W. Park St.
BWPC
Urbana, IL 61801-2500
Phone (217) 383-6792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20050304000134 IL Practitioner - Colorectal Surgery (Proctology) 7315991122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
University of Minnesota Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

200 Lerna Rd S
Mattoon, IL 61938-9388
Phone (217) 258-5900

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy52
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036073498ILMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated Colon & Rectal Surgery CurrentSince Apr 1, 2010 Accepting new patients
Kirby Medical Center CurrentSince Jan 3, 2026 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Past Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

721 E Court St
Paris, IL 61944
Phone (217) 465-4141

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

810 W Anthony Dr
Urbana, IL 61802
Phone (217) 326-2911

Organizations & group practices 5

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 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400630400000",
    "number": "1417068131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "COLON & RECTAL SURGERY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-3080",
            "fax_number": "217-383-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGEN",
        "first_name": "LYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036073498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.