LYDIA MARIE VETSCH – Student in an Organized Health Care Education/Training Program, NPI 1124703814

LYDIA MARIE VETSCH is a healthcare provider. based in Monticello, Minnesota. specializing in PHYSICIAN ASSISTANT. The NPI Number for LYDIA MARIE VETSCH is 1124703814

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
LYDIA MARIE VETSCH
NPI
1124703814
Phone
(763) 496-8616
Address
2531 Eastwood Ln
Enumeration Date
20 June 2023
Last Update Date
25 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7636821313
Graduation Year
2024 (2 years ago)
PAC ID
7911429774
Group Practice PAC ID
1153233796
Professional Enrollment ID
I20250320003754
Address ID
MN553131930BU1700XNXXX400

Contacts

Secure Messaging
lvetsch213585@direct.northmemorial.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness95
Years active:2State licenses:0Other names

4,031 PHYSICIAN ASSISTANT in MN

Provider Addresses for LYDIA MARIE VETSCH

  • 2531 Eastwood Ln

    Monticello, MN 553629556

    Phone: (763) 496-8616

    Type: Location

  • 1700 HIGHWAY 25 N

    BUFFALO, MN 553131930

    Phone: (763) 682-1313

    Fax: (763) 581-9090

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-03-20

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
I20250320003754IPhysician AssistantMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55362)

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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: 1153233796View full group profile
NameSpecialtyState
Internal MedicineMN
Internal MedicineMN
Family PracticeMN
Certified Nurse Midwife (Cnm)MN
Family PracticeMN
Family PracticeMN
Nurse PractitionerMN
Family PracticeMN
Physician AssistantMN
Physician AssistantMN

Reviews

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Frequently asked questions

Is LYDIA MARIE VETSCH listed with a National Provider Identifier?
Yes — LYDIA MARIE VETSCH has NPI 1124703814 on file in the registry.
Active or inactive — what applies to LYDIA MARIE VETSCH?
You should see LYDIA MARIE VETSCH as active in CMS-hosted NPPES data.
What kind of doctor is LYDIA MARIE VETSCH?
LYDIA MARIE VETSCH is associated with Student in an Organized Health Care Education/Training Program in the directory — Clinical services aligned with this taxonomy classification.
Is LYDIA MARIE VETSCH located near Monticello?
LYDIA MARIE VETSCH currently maps to Monticello, Minnesota in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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