NPIMap

Individual provider Active NPI

Tyler Lewandowski

  • Family Medicine Physician
  • Princeton, MN
National Provider Identifier
1669961215
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67295 Issued in MN
Practice address
911 Northland Dr
Princeton, MN 55371-2172
Phone
(633) 896-3067
NPI assigned
May 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 67295 MN Primary

Addresses

Primary practice location

911 Northland Dr
Princeton, MN 55371-2172

Mailing address

1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210617001124 MN Practitioner - Family Practice 7618224304 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

  • Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
  • Triniti Home Health and Hospice Home health agency, Elk River, MN, CCN 247263
  • Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141
  • M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Apr 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2021 Accepting new patients
Fairview Express Care CurrentSince Apr 1, 2021 Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2021 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2021 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: tlewandowski368834@fairview.direct-ci.com

Organizations & group practices 10

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 5

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1669961215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NORTHWAY DR STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 NORTHLAND DR",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553712172",
            "telephone_number": "633-896-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWANDOWSKI",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "67295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, MN

Sources for this page

Verify at the official NPI Registry.