Individual provider Active NPI

Lilly Helene Wagner, M.D.

  • Ophthalmology Physician
  • Rochester, MN
National Provider Identifier
1982990057
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
63927 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905
Phone
(507) 284-2511
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A142763 CA
Ophthalmology Physician 207W00000X 63927 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

2100 Webster St Ste 212
San Francisco, CA 94115-2375
Phone (415) 345-1274

Other names 1

  • Lilly Helene Droll Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwagner441192@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160614000891 CA Practitioner - Ophthalmology 1759672298 Reassigns benefits to 2 organizations
I20180730000740 MN Practitioner - Ophthalmology 1759672298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142763CAMDMarriage & Family Therapist
A142763CAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince Aug 15, 2018 Accepting new patients
Mayo Clinic CurrentSince Aug 15, 2018 Accepting new patients
University of California SFGH Medical Group Ophthalmology CurrentSince May 19, 2016 Accepting new patients
University of California SFGH Medical Group CurrentSince May 19, 2016 Accepting new patients
Pacific Center for Oculofacial and Aesthetic Plastic Surgery PC Ophthalmology CurrentSince Oct 18, 2016 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
Mayo Clinic Current Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

1241 E Hillsdale Blvd
Ste 240
Foster City, CA 94404
Phone (650) 340-9763

1001 Potrero Ave
Rm 3A
San Francisco, CA 94110
Phone (415) 206-4632

2100 Webster St
Ste 214
San Francisco, CA 94115
Phone (415) 923-3007

2100 Webster St
Ste 212
San Francisco, CA 94115
Phone (415) 923-3030

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: lwagner441192@ehrdirect.mayoclinicmsg.org

Organizations & group practices 8

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 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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1982990057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55905",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Webster St Ste 212",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941152375",
            "country_code": "US",
            "telephone_number": "415-345-1274",
            "fax_number": "415-345-1276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LILLY",
        "middle_name": "HELENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A142763",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "63927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwagner441192@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LILLY",
            "last_name": "DROLL",
            "middle_name": "HELENE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.