NPIMap

Individual provider Active NPI

Paul J Lysne, MD

  • Family Medicine Physician
  • Andover, MN
National Provider Identifier
1912971706
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36180 Issued in MN
Practice address
15245 Bluebird St NW
Andover, MN 55304-3554
Phone
(763) 587-4600
Fax
(763) 587-4615
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36180 MN Primary

Addresses

Primary practice location

15245 Bluebird St NW
Andover, MN 55304-3554

Mailing address

15245 Bluebird St NW
Andover, MN 55304-3554
Phone (763) 587-4600

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
I20041113000233 MN Practitioner - Family Practice 6608830294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

11475 Robinson Dr NW
Coon Rapids, MN 55433-3746
Phone (763) 754-0041

15245 Bluebird NWST
Andover, MN 55304-3554
Phone (763) 712-6000

2621 Greenhaven Rd
Anoka, MN 55303-1776
Phone (952) 853-8800

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

530 3Rd St NW
Elk River, MN 55330-1445
Phone (763) 712-6000

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Brooklyn Park, MN, CCN 247145
  • Allina Health Home Health Home health agency, Minneapolis, MN, CCN 248091
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115
  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Nov 1, 2004 Accepting new patients
Group Health, Inc. CurrentSince Nov 1, 2004 Accepting new patients

Locations

15245 Bluebird St NW
Anoka, MN 55304
Phone (763) 587-4600

11475 Robinson Dr NW
#32600A
Minneapolis, MN 55433
Phone (763) 587-9000

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

Interoperability endpoints

  • Direct secure messaging: plysne21034@direct.healthpartners.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1912971706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043554",
            "telephone_number": "763-587-4600",
            "fax_number": "763-587-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 BLUEBIRD ST NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043554",
            "telephone_number": "763-587-4600",
            "fax_number": "763-587-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSNE",
        "first_name": "PAUL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "36180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MN

Sources for this page

Verify at the official NPI Registry.