NPIMap

Individual provider Active NPI

Jack Lansing, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1750126108
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14994 Issued in MN
Practice address
1000 E 1St St Ste LL
Duluth, MN 55805-2297
Phone
(218) 249-6230
NPI assigned
Jun 27, 2024
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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 14994 MN Primary

Addresses

Primary practice location

1000 E 1St St Ste LL
Duluth, MN 55805-2297

Mailing address

1000 E 1St St Ste LL
Duluth, MN 55805-2297
Phone (218) 249-6230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240807002769 MN Practitioner - Physician Assistant 1254878267 Reassigns benefits to 1 organization
I20250909001347 WI Practitioner - Physician Assistant 1254878267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke's Hospital of DuluthGroup PAC ID 7113834839, shared by 9 NPIs, 409 clinicians

Practice addresses (Care Compare)

1000 E 1St St
Duluth, MN 55805-2297

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

109 N 28TH St E
Superior, WI 54880-6548
Phone (715) 395-3900

1615 Maple LN
Ashland, WI 54806-3610
Phone (715) 685-5500

2201 Lake Shore Dr E
Ashland, WI 54806-2331
Phone (715) 685-6600

512 Skyline Blvd
Cloquet, MN 55720-3787
Phone (218) 879-4641

8373 Unity Dr
Virginia, MN 55792-4005
Phone (218) 748-7480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Hospital of Duluth CurrentSince Jul 29, 2024 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince May 24, 2025 Accepting new patients
St. Luke's Hospital of Duluth CurrentSince Jul 29, 2024 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1000 E 1st St
Ste Ll
Duluth, MN 55805
Phone (218) 249-4700

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: jlansing350405@direct.aspirus.org

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 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1750126108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST STE LL",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-249-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 1ST ST STE LL",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052297",
            "telephone_number": "218-249-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANSING",
        "first_name": "JACK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.