Individual provider Active NPI

Rebecca R Lyman, M.D.

  • Family Medicine Physician
  • Saint Croix Falls, WI
National Provider Identifier
1932201720
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37760 Issued in WI
Practice address
235 E State St
Saint Croix Falls, WI 54024-4117
Phone
(715) 483-3221
Fax
(715) 483-0507
NPI assigned
Sep 2, 2006
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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 37760 WI Primary

Addresses

Primary practice location

235 E State St
Saint Croix Falls, WI 54024-4117

Mailing address

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

Other identifiers 8

IdentifierTypeStateIssuer
32233100MedicaidWI
64Q32LYOtherMNBLUE CROSS MN PRO FEE
HP19421OtherHEALTHPARTNERS
475518900MedicaidMN
NA9031011612OtherPREFERREDONE
0110870OtherMEDICA
080099998OtherRAILROAD
27G41LYOtherMNBLUE CROSS MN FACILITY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rlyman154287@excellian.direct.allina.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100706000726 WI Practitioner - Family Practice 6406987577 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians

Practice addresses (Care Compare)

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Regional Medical Center CurrentSince Aug 2, 1996 Accepting new patients
St. Croix Regional Medical Center CurrentSince Aug 2, 1996 Accepting new patients

Locations

1504 190th Ave
Balsam Lake, WI 54810
Phone (715) 825-3278

205 Oak St W
Frederic, WI 54837
Phone (715) 327-5700

204 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-3221

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

26425 Lakeland Ave S
Webster, WI 54893
Phone (715) 866-4271

Interoperability endpoints

  • Direct secure messaging: rlyman154287@excellian.direct.allina.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Croix Falls ClinicSaint Croix Falls, WI, CCN 528604 Rural health clinic Corporate Director Sep 1, 2018
Unity ClinicBalsam Lake, WI, CCN 528605 Rural health clinic Corporate Director Sep 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 1

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1932201720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "REBECCA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32233100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MN  PRO FEE",
            "identifier": "64Q32LY",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP19421",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "475518900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERREDONE",
            "identifier": "NA9031011612",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0110870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "080099998",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MN  FACILITY",
            "identifier": "27G41LY",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlyman154287@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDFTXT",
            "address_1": "235 E State St",
            "city": "Saint Croix Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540244117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Croix Falls, WI

Sources for this page

Verify at the official NPI Registry.