JOSEPH WILLIAM LACKNER PA-C
NPI 1073477089
Physician Assistant in Grand Rapids, MN

Q: What is Joseph Lackner's NPI number?

The NPI number for Joseph Lackner is 1073477089. It was assigned to this individual provider in the NPPES registry on December 13, 2025.

Q: What is Joseph Lackner's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Joseph Lackner was last updated on December 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since December 13, 2025PECOS EnrolledAccepts Medicare Assignment

1601 GOLF COURSE RD, GRAND RAPIDS, MN 55744(218) 326-3401 Get Directions Write a Review

NPPES record last updated: December 13, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Joseph William Lackner Pa-c NPPES

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

JOSEPH WILLIAM LACKNER PA-C (NPI 1073477089) is an individual physician assistant in Grand Rapids, Minnesota, licensed in Minnesota (15633) and active in the NPI registry since December 2025. He is enrolled in Medicare PECOS, is affiliated with Grand Itasca Clinic And Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1073477089

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJOSEPH WILLIAM LACKNERCredential: PA-C

Location Address1601 GOLF COURSE RDGrand Rapids, MN 55744-8648

Mailing Address209 3rd St SVirginia, MN 55792-2619

Phone(218) 326-3401

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateDecember 13, 2025

NPPES CertifiedDecember 13, 2025

✔ NPI 1073477089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MN · 15633

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1601 GOLF COURSE RD, Grand Rapids, MN 55744

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Joseph William Lackner Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264910835

PECOS Enrollment IDI20260204001116

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Grand Itasca Clinic And Hospital

Acute Care Hospitals · Grand Rapids, MN

OwnershipVoluntary non-profit - Private

CMS Certification Number240064

Location1601 Golf Course RoadGrand Rapids, MN 55744 · Itasca County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55744 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JESSICA JO DAY NURSE PRACTITIONER

Nurse Practitioner (Family)