Dr Lisa Joan Nippoldt-baca, PSYD, LP, ABPP is a medicare enrolled "Clinical Neuropsychologist" provider in Woodbury, Minnesota. Her current practice location is
1937 Woodlane Drive, Suite 101, Woodbury, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(651) 764-8480.
Dr Lisa Joan Nippoldt-baca is licensed to practice in Minnesota (license number LP5271) 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 1720314909.
Healthcare Provider's Profile
| Full Name | Dr Lisa Joan Nippoldt-baca |
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| Gender | Female |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1937 Woodlane Drive, Woodbury, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1720314909
- Provider Enumeration Date: 10/23/2009
- Last Update Date: 04/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 5496871709
- Enrollment ID: I20100923001307
Medical Identifiers
Medical identifiers for Dr Lisa Joan Nippoldt-baca such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720314909 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | LP5271 (Minnesota) | Secondary |
| 103G00000X | Clinical Neuropsychologist | LP5271 (Minnesota) | Primary |
| 103T00000X | Psychologist | LP5271 (Minnesota) | Secondary |
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. Dr Lisa Joan Nippoldt-baca allows following entities to bill medicare on her behalf.
| Entity Name | Minneapolis Clinic Of Neurology Ltd |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992739247
PECOS PAC ID: 5496668659
Enrollment ID: O20031112000572 |
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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. Dr Lisa Joan Nippoldt-baca 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 |
|---|
Dr Lisa Joan Nippoldt-baca, PSYD, LP, ABPP
1937 Woodlane Drive, Suite 101,
Woodbury, MN 55125
Ph: (651) 764-8480 | Dr Lisa Joan Nippoldt-baca, PSYD, LP, ABPP
1937 Woodlane Drive, Suite 101,
Woodbury, MN 55125
Ph: (651) 764-8480 |
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