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DR. LISA R. IRVIN M.D.
NPI 1124095575
Pediatrics in St Louis Park, MN

Active since March 03, 2006PECOS Enrolled
3910 EXCELSIOR BLVD, ST LOUIS PARK, MN 55416(952) 562-8787(952) 562-8788 Get Directions Write a Review

NPPES record last updated: September 22, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Lisa R. Irvin M.d. NPPES

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

DR. LISA R. IRVIN M.D. (NPI 1124095575) is an individual pediatrics provider in St Louis Park, Minnesota, licensed in Minnesota (41186) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124095575
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. LISA R. IRVINCredential: M.D.
Location Address3910 EXCELSIOR BLVDSt Louis Park, MN 55416-4709
Mailing Address3910 Excelsior BlvdSt Louis Park, MN 55416-4709 · (952) 562-8787 · Fax (952) 562-8788
Phone(952) 562-8787
Fax(952) 562-8788
Sole ProprietorNo
Enumeration DateMarch 3, 2006
Last NPPES UpdateSeptember 22, 2011
✔ NPI 1124095575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MN · 41186
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3910 EXCELSIOR BLVD, St Louis Park, MN 55416
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Other Identifiers 2

Medicaid294718800MN
Medicare UPING97232MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa R. Irvin M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 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
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
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 2

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

DR. SARALYN KLEIN M.D.
Pediatrics
3910 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 562-8787
DR. BRUCE E. CANTOR M.D.
Pediatrics
3910 EXCELSIOR BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 562-8787

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 Lisa Irvin's NPI number?

The NPI number for Lisa Irvin is 1124095575. It was assigned to this individual provider in the NPPES registry on March 3, 2006.

Where is Lisa Irvin located?

Lisa Irvin practices at 3910 Excelsior Blvd, St Louis Park, MN 55416. The listed phone number is (952) 562-8787.

What is Lisa Irvin's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Lisa Irvin enrolled in Medicare?

Yes. Lisa Irvin is registered in the Medicare PECOS enrollment system.

What insurance does Lisa Irvin accept?

Health plans from HealthPartners and Medica list Lisa Irvin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Irvin was last updated on September 22, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.