Individual provider Active NPI

Cody Thomas Lemay, PA-C

  • Physician Assistant
  • Duluth, MN
National Provider Identifier
1942777529
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12980 Issued in MN
Practice address
1012 E 2ND St
Duluth, MN 55805-2200
Phone
(218) 249-6360
Fax
(218) 249-6370
NPI assigned
Oct 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12980 MN Primary

Addresses

Primary practice location

1012 E 2ND St
Duluth, MN 55805-2200

Mailing address

1012 E 2ND St
Duluth, MN 55805-2200
Phone (218) 249-6360

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@slk.direct.slhduluth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190416003277 MN Practitioner - Physician Assistant 5799026969 Reassigns benefits to 1 organization
I20200518002602 WI Practitioner - Physician Assistant 5799026969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Luke'S Hospital of DuluthGroup PAC ID 7113834839, 409 clinicians

Practice addresses (Care Compare)

1011 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7000

1015 E 1St St
Duluth, MN 55805-2242
Phone (218) 249-7860

915 E 1St St
Duluth, MN 55805-2107
Phone (218) 249-5439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Hospital of Duluth CurrentSince Apr 1, 2019 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Apr 13, 2020 Accepting new patients
St. Luke'S Hospital of Duluth CurrentSince Apr 1, 2019 Accepting new patients
St. Luke'S Hospital of Duluth Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

920 E 1st St
Ste P101
Duluth, MN 55805
Phone (218) 279-6200

1015 E 1st St
Duluth, MN 55805
Phone (218) 249-7860

915 E 1st St
Duluth, MN 55805
Phone (218) 249-5352

109 N 28th St E
Superior, WI 54880
Phone (715) 395-3900

Interoperability endpoints

  • Direct secure messaging: clemay237271@direct.aspirus.org

Organizations & group practices 6

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 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1942777529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-6360",
            "fax_number": "218-249-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052200",
            "telephone_number": "218-249-6360",
            "fax_number": "218-249-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMAY",
        "first_name": "CODY",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-31",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@slk.direct.slhduluth.com",
            "affiliation": "N",
            "address_1": "1012 E 2nd St",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558052200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.