LUCKY VANG (D.O.) – Surgery Physician, NPI 1053627364

LUCKY VANG (D.O.) is a healthcare provider. based in Marshall, Minnesota. specializing in GENERAL SURGERY. They hold the professional credentials D.O.. They hold a License No. 5151009660 (MI). The NPI Number for LUCKY VANG (D.O.) is 1053627364

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
LUCKY VANG (D.O.)
NPI
1053627364
Phone
(651) 276-6787
Address
300 S BRUCE ST
Enumeration Date
24 August 2010
Last Update Date
30 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512327800
Graduation Year
2015 (11 years ago)
PAC ID
7517277205
Group Practice PAC ID
3971407636
Professional Enrollment ID
I20200616001862
Address ID
MN551091242MA2945XSTXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

730 GENERAL SURGERY in MN

Provider Addresses for LUCKY VANG (D.O.)

  • 300 S BRUCE ST

    MARSHALL, MN 562581934

    Phone: (651) 276-6787

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 37 Open Payments records for all available years, with a total value of $12,130.

Total Amount is formed as General ($12,130) + Research ($0) + Ownership ($0) = $12,130.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($10,207).

Total Amount

$12,130

General + Research + Ownership

Payments

37

Total payment records

General Amount

$12,130

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-06-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200616001862IGeneral SurgeryMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes6644$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes5351$0
99221Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes2626$0
47562Removal of gallbladder using an endoscope1515$0
View full utilization report →

Insurance plans in this area (ZIP 56258)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971407636View full group profile

Reviews

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Frequently asked questions

How do I look up LUCKY VANG (D.O.) by NPI?
Use NPI 1053627364 when you need to reference LUCKY VANG (D.O.) in forms, claims, or directories.
Is LUCKY VANG (D.O.) currently active in the NPI registry?
CMS-published data lists LUCKY VANG (D.O.) as an active registrant.
What does LUCKY VANG (D.O.) treat or focus on?
Patients typically see LUCKY VANG (D.O.) under the specialty Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is LUCKY VANG (D.O.)'s primary listing?
We display Marshall, Minnesota because that is what the record indicates for LUCKY VANG (D.O.).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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