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CALLEY A. LIDLE M.D.
NPI 1851513436
Pediatrics in St. Paul, MN

Active since May 03, 2007PECOS Enrolled
233 GRAND AVENUE, ST. PAUL, MN 55102(651) 227-7806(651) 256-6707 Get Directions Write a Review

NPPES record last updated: July 2, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Calley A. Lidle M.d. NPPES

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

CALLEY A. LIDLE M.D. (NPI 1851513436) is an individual pediatrics provider in St. Paul, Minnesota, licensed in Minnesota (51175) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851513436
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameCALLEY A. LIDLECredential: M.D.
Location Address233 GRAND AVENUESt. Paul, MN 55102-9658
Mailing Address233 Grand AvenueSt. Paul, MN 55102-9658 · (651) 227-7806 · Fax (651) 256-6707
Phone(651) 227-7806
Fax(651) 256-6707
Sole ProprietorNo
Enumeration DateMay 3, 2007
Last NPPES UpdateJuly 2, 2009
✔ NPI 1851513436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in MN · 51175✔ Licensed in IL · 125050402✔ Licensed in WI · 52074-020
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.
233 GRAND AVENUE, St. Paul, MN 55102
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Other Names 1

Former Name (1)Calley A. Kennedy M.d.

Other Identifiers 1

Medicaid185153436MN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Calley A. Lidle 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.

Medicare Billing Reassignment

Medicare enrollment records show Calley Lidle reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Healtheast Medical Research Insititue
0.6 mi
Internal Medicine
45 10TH STREET WEST
Saint Paul, MN 55102
  • Reassigned Medicare billing, Minnesota enrollment
  • Medicare enrollment name: Healtheast Medical Research Institute
  • 2,361 clinicians in this Medicare group
NPI 1417145517 (651) 232-3000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55102 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

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

DR. TAMMI S PLOTNIK MD
Pediatrics
233 GRAND AVENUE
ST PAUL, MN 55102
Ramsey County (651) 227-7806

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 Calley Lidle's NPI number?

The NPI number for Calley Lidle is 1851513436. It was assigned to this individual provider in the NPPES registry on May 3, 2007. The provider is also known as Calley A. Kennedy M.D..

Where is Calley Lidle located?

Calley Lidle practices at 233 Grand Avenue, St. Paul, MN 55102. The listed phone number is (651) 227-7806.

What is Calley Lidle's specialty?

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

Is Calley Lidle enrolled in Medicare?

Yes. Calley Lidle is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Calley Lidle's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Calley Lidle reassigns Medicare benefits to Healtheast Medical Research Insititue (Saint Paul, MN). The 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 Calley Lidle's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Calley Lidle was last updated on July 2, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.