Nicolle Michelle Lande, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9821 Issued in MN

Practice address

2550 University Avenue West
Suite 229N
St Paul, MN 55114

Phone

(651) 645-3115

Fax

(651) 645-2752

NPI assigned

Dec 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psych Recovery IncGroup PAC ID 3779633912, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Psych Recovery Inc

  • Psychiatry Physician
  • Saint Paul, MN
  • NPI 1316189541
  Medicare reassignment Care Compare group
• Aris Behavioral Health LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Woodbury, MN
  • NPI 1083385231
  NPD (past)
• Psychiatric Recovery PA

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Paul, MN
  • NPI 1891713681
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1881671162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVENUE WEST",
            "address_2": "SUITE 229N",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55114",
            "telephone_number": "651-645-3115",
            "fax_number": "651-645-2752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVENUE WEST",
            "address_2": "SUITE 229N",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "55114",
            "telephone_number": "651-645-3115",
            "fax_number": "651-645-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDE",
        "first_name": "NICOLLE",
        "middle_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "486965800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "559K0LA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Jean McGough Lamere, PA-C
• Susan Mae Lamoureux, LICSW
• Jillian Lampert, R.D.
• Robert A Lamppa, CRNA
• Carolyn Lanctin, OTD, OTR/L
• Freya Kristen Landesman
• Elisha Landowski, LICSW
• Andree Kay Landrum, LICSW
• Gina Landsee, MSED, LPCC, LADC
• Kelsey Elizabeth Lane

• Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.