Rebecca R Lyman, M.D.
Individual provider Active NPI Family Medicine Physician · Saint Croix Falls, WI
NPI 1932201720 · NPPES record last updated Jan 15, 2021
Key facts
- NPI
- 1932201720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 37760 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- 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 Center
Practice addresses (Care Compare)
235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221
Hospital & facility affiliations
- St Croix Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| St. Croix Falls Clinic |
Rural health clinic | Corporate Director | Sep 1, 2018 |
| Unity Clinic |
Rural health clinic | Corporate Director | Sep 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100706000726 | WI | Practitioner - Family Practice | 6406987577 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37760 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Croix Regional Medical Center | Current |
Accepting new patients | |
| St. Croix Regional Medical Center | Current |
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
235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221
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
26425 Lakeland Ave S
Webster, WI 54893
Phone (715) 866-4271
Interoperability endpoints
- rlyman154287@excellian.direct.allina.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37760 | WI | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0110870 | Other | MEDICA | |
| 32233100 | Medicaid | WI | |
| 080099998 | Other | RAILROAD | |
| 64Q32LY | Other | MN | BLUE CROSS MN PRO FEE |
| NA9031011612 | Other | PREFERREDONE | |
| HP19421 | Other | HEALTHPARTNERS | |
| 27G41LY | Other | MN | BLUE CROSS MN FACILITY |
| 475518900 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rlyman154287@excellian.direct.allina.com | Direct |
Other providers in Saint Croix Falls, WI
- Nanette Liegeois
- Victoria J Lien
- Lincare Inc.
- Mariele Lindeman
- Kelly J Luschen
- Abbey Makens
- Emanuele Marchisio
- Charles W Mayo II
- Liisa M Mayo
- Steven L McCormack
All providers in Saint Croix Falls, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.