NPIMap

Individual provider Active NPI

Lisa M Bolin, MD

  • Pulmonary Disease Physician
  • St Louis Park, MN
National Provider Identifier
1710964937
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
44513 Issued in MN
Practice address
6490 Excelsior Blvd
Ste W300
St Louis Park, MN 55426-4705
Phone
(952) 993-3242
NPI assigned
Dec 29, 2005
Last updated
Jul 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 44513 MN Primary

Addresses

Primary practice location

6490 Excelsior Blvd
Ste W300
St Louis Park, MN 55426-4705

Mailing address

6465 Wayzata Blvd
Ste 315
St Louis Park, MN 55426-1728

Other identifiers 1

IdentifierTypeStateIssuer
082087300MedicaidMN

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
I20050413000281 MN Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep MedicinePractitioner - Internal Medicine 3375580137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hutchinson HealthGroup PAC ID 0345330072, 145 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

1029 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4400

1071 Hwy 15 S
Hutchinson, MN 55350-3153
Phone (320) 484-4610

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

3 Century Ave SE
Hutchinson, MN 55350-3108
Phone (320) 234-3290

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hutchinson Health CurrentSince Jul 2, 2023 Accepting new patients
Park Nicollet Clinic CurrentSince Jan 1, 2006 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Park Nicollet Clinic CurrentSince Jan 1, 2006 Accepting new patients
Hutchinson Medical Center PA Past Accepting new patients

Locations

1029 Highway 15 S
Hutchinson, MN 55350
Phone (320) 275-3358

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

6490 Excelsior Blvd
Ste W300
St Louis Park, MN 55426
Phone (952) 993-3242

6500 Excelsior Blvd
St Louis Park, MN 55426
Phone (952) 993-3246

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1710964937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 WAYZATA BLVD",
            "address_2": "STE 315",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 EXCELSIOR BLVD",
            "address_2": "STE W300",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264705",
            "telephone_number": "952-993-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "44513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082087300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.