Lisa Grundtner, MD is a medicare enrolled "Hospitalist" physician in Saint Louis Park, Minnesota. Her current practice location is
6500 Excelsior Blvd, Saint Louis Park, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(952) 993-5000.
Lisa Grundtner is licensed to practice in Minnesota (license number 71055) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1730744699.
Physician's Profile
Full Name | Lisa Grundtner |
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Gender | Female |
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Speciality | Hospitalist |
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Location | 6500 Excelsior Blvd, Saint Louis Park, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1730744699
- Provider Enumeration Date: 05/07/2019
- Last Update Date: 08/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 8325375652
- Enrollment ID: I20231023000454
Medical Identifiers
Medical identifiers for Lisa Grundtner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730744699 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 71055 (Minnesota) | Secondary |
208M00000X | Hospitalist | 71055 (Minnesota) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Grundtner allows following entities to bill medicare on her behalf.
Entity Name | Park Nicollet Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
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Entity Name | Hutchinson Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1053508820 PECOS PAC ID: 0345330072 Enrollment ID: O20080312000695 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lisa Grundtner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Lisa Grundtner, MD 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () - | Lisa Grundtner, MD 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 Ph: (952) 993-5000 |
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