Individual provider Active NPI

Debra Mary McGuire Lang, PA-C

  • Physician Assistant
  • Faribault, MN
National Provider Identifier
1649233081
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9516 Issued in MN
Practice address
1645 Lyndale Ave N Ste 103
Faribault, MN 55021-2935
Phone
(651) 968-5201
Fax
(651) 968-5904
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9516 MN Primary

Addresses

Primary practice location

1645 Lyndale Ave N Ste 103
Faribault, MN 55021-2935

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5201

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
I20050110000370 MN Practitioner - Physician Assistant 2860440526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northfield HospitalGroup PAC ID 2567372998, 121 clinicians

Practice addresses (Care Compare)

1381 Jefferson Rd
Northfield, MN 55057-3080
Phone (507) 646-8900

1980 30TH St NW
Faribault, MN 55021-1846
Phone (507) 333-5499

2000 N a Ve
Northfieldm, MN 55057-1498

2000 N Ave
Northfield, MN 55057-1498
Phone (507) 646-1478

4645 Knutsen Dr
Farmington, MN 55024-8455
Phone (651) 460-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9516MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northfield Hospital CurrentSince Feb 18, 2024 Accepting new patients

Locations

2000 North Ave
Northfield, MN 55057
Phone (507) 646-1000

Organizations & group practices 2

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 3

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649233081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LYNDALE AVE N STE 103",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550212935",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE LANG",
        "first_name": "DEBRA",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.