Individual provider Active NPI

Comfort Lumyedang Nchanji, MD

  • Family Medicine Physician
  • Crystal, MN
National Provider Identifier
1609493147
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036165756 Issued in IL
Practice address
6014 Lakeland Ave N
Crystal, MN 55428-2984
Phone
(612) 871-2312
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036165756 IL Primary

Addresses

Primary practice location

6014 Lakeland Ave N
Crystal, MN 55428-2984

Mailing address

5035 S East End Ave Apt 803S
Chicago, IL 60615-0041
Phone (651) 500-4281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230903000007 IL Practitioner - Family Practice 6800259144 Reassigns benefits to 3 organizations
I20260525000444 MN Practitioner - Family Practice 6800259144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Odam Medical GroupGroup PAC ID 4082911938, 3 clinicians

Practice addresses (Care Compare)

6014 Lakeland Ave N
Crystal, MN 55428-2984
Phone (612) 871-2312

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Odam Medical Group CurrentSince Jul 1, 2025 Accepting new patients
Physicians Medical Services, LTD. Family Medicine CurrentSince Feb 13, 2024 Accepting new patients
Odam Medical Group CurrentSince Jul 1, 2025 Accepting new patients
Nchanji PLLC Family Medicine CurrentSince Sep 19, 2024 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Dec 26, 2023 Accepting new patients
Midwest Express Care 2, Inc Family Medicine CurrentSince Dec 26, 2023 Accepting new patients

Locations

779 W Adams St
Chicago, IL 60661
Phone (312) 382-8308

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

2158 45th St
Highland, IN 46322
Phone (219) 554-0500

6014 Lakeland Ave N
Minneapolis, MN 55428
Phone (612) 871-2312

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1609493147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 S EAST END AVE APT 803S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606150041",
            "telephone_number": "651-500-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6014 LAKELAND AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554282984",
            "telephone_number": "612-871-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NCHANJI",
        "first_name": "COMFORT",
        "middle_name": "LUMYEDANG",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036165756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

Verify at the official NPI Registry.