Lacey Ann Langerak, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

11187 Issued in MN

Practice address

1300 Anne St NW
Bemidji, MN 56601-5103

Phone

(218) 751-9746

NPI assigned

Oct 27, 2005

Last updated

Sep 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of North Dakota School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians

Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Sanford Health of Northern MinnesotaGroup PAC ID 5597725168, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sanford Bemidji Medical Center Hospital, Bemidji, MN, CCN 240100
• Lakewood Health Center Hospital, Baudette, MN, CCN 241301
• Rainy Lake Medical Center Hospital, International Falls, MN, CCN 241322
• Sanford Bagley Medical Center Hospital, Bagley, MN, CCN 241328

Merit-based Incentive Payment System (MIPS)

Final score

86.56 of 100Reported as group

Quality

74.25

Promoting interoperability

100

Improvement activities

40

Cost

76.16

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Health of Northern Minnesota

  dba Sanford Health Kelliher Clinic

  • Family Medicine Physician
  • Kelliher, MN
  • NPI 1770849697
  Medicare reassignment Care Compare group
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149
  NPD

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

• International Falls Memorial Hospital Association

  dba Rainy Lake Medical Center

  • Critical Access Hospital
  • International Falls, MN
  • NPI 1528041183
  Care Compare affiliation
• Lakewood Health Center

  dba CHI Lakewood Health

  • Critical Access Hospital
  • Baudette, MN
  • NPI 1922072776
  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Joe Lueken Cancer Center

  • Internal Medicine Physician
  • Bemidji, MN
  • NPI 1780628149

  Hospital

  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Sanford Bemidji Medical Center

  • Rural Acute Care Hospital
  • Bemidji, MN
  • NPI 1801870191
  Care Compare affiliation
• Sanford Health of Northern Minnesota

  dba Sanford Bagley Medical Center

  • Critical Access Hospital
  • Bagley, MN
  • NPI 1932472255
  Care Compare affiliation

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1811987118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-751-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-751-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGERAK",
        "first_name": "LACEY",
        "middle_name": "ANN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11187",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "11187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakes Region Chemical Dependency LLC
• Lakeview Dental Clinic
• Lakeview Health and Wellness PLLC (Lakeview Chiropractic)
• Mary H. Landes, C.R.N.A.
• Kirsten Landmark, MS
• Paul J Lappinga, MD
• Jeffrey Large, MPT
• Madisson Michelle Larson
• Sadie Lynn Larson
• Amie Jean Lauderbaugh

• Surgical Physician Assistant in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Surgical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.

Verify at the official NPI Registry.