MARTIN S LACEY MD NPI 1821064288

NPI Information

NPI: 1821064288
Provider Name: MARTIN S LACEY, MD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

Organization: GILLETTE CHILDRENS SPECIALTY HEALTHCARE

PECOS Registration: Yes

Address:
640 JACKSON ST
MC 11503B
SAINT PAUL, MN
ZIP 55101
Phone: (651) 254-3792
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Martin S Lacey, MD is a plastic and reconstructive surgery surgery in Saint Paul, MN with 42 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. Martin S Lacey, MD NPI is 1821064288. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

640 JACKSON ST
MC 11503B
SAINT PAUL, MN
ZIP 55101-502
Phone: (651) 254-3792
Fax: (651) 254-8208

The NPI 1821064288 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/27/2006 and was last updated on 10/23/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery	45762	WISCONSIN	No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery	44353	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	240000255	MEDICARE ID-TYPE UNSPECIFIED
2	H61611	MEDICARE UPIN
3	322800200	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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