Active NPI
Ezra Lyon, M.D.
- Family Medicine Physician
- Wausau, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 69896
- Practice address
- 1810 N 2ND St
Wausau, WI 54403-3492 - Phone
- (715) 848-4884
- Fax
- (715) 845-5385
- NPI assigned
- Apr 12, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 207VX0000X | 69896 | WI | |
| Family Medicine Physician | 207Q00000X | 69896 | WI | Primary |
Addresses
Primary practice location
1810 N 2ND St
Wausau, WI 54403-3492
Mailing address
1810 N 2ND St
Wausau, WI 54403-3492
Phone (715) 848-4884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1810 N 2ND St
Wausau, WI 54403-3492
Phone (715) 848-4884
Hospital & facility affiliations
- Aspirus Wausau Hospital
- Thedacare Medical Center-Waupaca
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69896 | WI | MD | Obstetrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Family Medicine | Current | Accepting new patients |
| Primary Connection Health Care, Inc. | Family Medicine | Current | Accepting new patients |
Locations
4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000
800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000
710 Riverside Dr
Waupaca, WI 54981
Phone (715) 256-3000
1810 N 2nd St
Wausau, WI 54403
Phone (715) 848-4884
Interoperability endpoints
- elyon203131@direct.thedacare.org
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.
-
- Federally Qualified Health Center (FQHC)
- Wausau, WI
- NPI 1457370744
Family Medicine
-
- Family Medicine Physician
- New London, WI
- NPI 1376656959
Hospital & facility affiliations 12
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1558363986
-
- General Acute Care Hospital
- Stevens Point, WI
- NPI 1598375271
-
- General Acute Care Hospital
- Wausau, WI
- NPI 1902923170
-
- Critical Access Hospital
- Waupaca, WI
- NPI 1013995521
-
- Critical Access Hospital
- Waupaca, WI
- NPI 1710333893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1669906004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1810 N 2ND ST",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544033492",
"telephone_number": "715-848-4884",
"fax_number": "715-845-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1810 N 2ND ST",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544033492",
"telephone_number": "715-848-4884",
"fax_number": "715-845-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYON",
"first_name": "EZRA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-04-12",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207VX0000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Obstetrics",
"state": "WI",
"license": "69896",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "69896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.