Active NPI
John M Lacika, M.D.
- Diagnostic Radiology Physician
- Sartell, MN
National Provider Identifier
1699775114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 23577
- Practice address
- 1990 Connecticut Ave S
Sartell, MN 56377-2554 - Phone
- (320) 257-5595
- Fax
- (320) 257-5596
- NPI assigned
- Jul 27, 2005
- Last updated
- Aug 11, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 23577 | MN | Primary |
Addresses
Primary practice location
1990 Connecticut Ave S
Sartell, MN 56377-2554
Mailing address
PO Box 7366
Saint Cloud, MN 56302-7366
Phone (320) 257-5595
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 411772562 | Other | MN | GREATWEST HEALTHCARE |
| 923872700 | Medicaid | MN | |
| 16-29699 | Other | MN | MEDICA |
| 965251008759 | Other | MN | PREFERRED ONE |
| HP25471 | Other | MN | HEALTH PARTNERS |
| 111023C561 | Other | MN | UCARE OF MINNESOTA |
| 26648 | Other | MN | ARAZ/ AMERICA'S PPO |
| 300039114 | Other | MN | RAILROAD MEDICARE |
| 54887LA | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Imaging LLC | Diagnostic Radiology | Past | Accepting new patients |
| Minnesota Radiology Institute | Diagnostic Radiology | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Alliance Imaging
- Diagnostic Radiology Physician
- Saint Cloud, MN
- NPI 1457967234
-
- Diagnostic Radiology Physician
- Crosby, MN
- NPI 1982783148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1313020800000",
"number": "1699775114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7366",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563027366",
"telephone_number": "320-257-5595",
"fax_number": "320-257-5596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1990 CONNECTICUT AVE S",
"city": "SARTELL",
"state": "MN",
"postal_code": "563772554",
"telephone_number": "320-257-5595",
"fax_number": "320-257-5596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACIKA",
"first_name": "JOHN",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-27",
"last_updated": "2011-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "23577",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREATWEST HEALTHCARE",
"identifier": "411772562",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "923872700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "16-29699",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "965251008759",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25471",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE OF MINNESOTA",
"identifier": "111023C561",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ/ AMERICA'S PPO",
"identifier": "26648",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300039114",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "54887LA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sartell, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.