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LIFE CLINIC PLLC
NPI 1033927744
Family Medicine in New Hope, MN

Active since December 27, 2024CLIA 24D2320151 · Microscopy
9220 BASS LAKE RD, NEW HOPE, MN 55428(651) 237-3763(651) 300-0992 Get Directions Write a Review

NPPES record last updated: December 27, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Life Clinic Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE CLINIC PLLC (NPI 1033927744) is a healthcare organization registered as a family medicine in New Hope, Minnesota and active in the NPI registry since December 2024. The organization holds a CLIA Microscopy certificate valid through March 12, 2027 and lists Isaac Adediran, President, as its authorized official.

NPPES Registry Identity

NPI1033927744
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLIFE CLINIC PLLC
Location Address9220 BASS LAKE RDNew Hope, MN 55428-3000
Mailing Address9220 Bass Lake RdNew Hope, MN 55428-3000 · (651) 237-3763 · Fax (651) 300-0992
Phone(651) 237-3763
Fax(651) 300-0992
Organization SubpartNo
Authorized OfficialIsaac AdediranPresident · (651) 237-3763
Enumeration DateDecember 27, 2024
NPPES CertifiedDecember 27, 2024
✔ NPI 1033927744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9220 BASS LAKE RD, New Hope, MN 55428
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Life Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Life Clinic PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Isaac Adediran, M.D
Family Practice
NPI 1063826998
1415 LILAC DR N STE 190
Golden Valley, MN 55422
(763) 267-8701
✔ PECOS✔ Accepts Medicare5.0 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 24D2320151

Life Clinic · New Hope, MN
Active · expires Mar 12, 2027
CLIA Number24D2320151
Laboratory TypePhysician Office
Certificate Effective DateMarch 13, 2025
Certificate Expiration DateMarch 12, 2027
Laboratory DirectorIsaac A. Adediran
Laboratory Phone(651) 237-3763
Laboratory LocationLife Clinic9200 Bass Lake Rd., Suite 265, New Hope, MN 55428
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Clinic PLLC's NPI number?

The NPI number for Life Clinic PLLC is 1033927744. It was assigned to this organization in the NPPES registry on December 27, 2024.

Where is Life Clinic PLLC located?

Life Clinic PLLC is located at 9220 Bass Lake Rd, New Hope, MN 55428. The listed phone number is (651) 237-3763.

What is Life Clinic PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Life Clinic PLLC enrolled in Medicare?

Yes. Life Clinic PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Life Clinic PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Life Clinic PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Life Clinic PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 24D2320151) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Life Clinic PLLC was last updated on December 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.