MARTIN S LACEY (MD) – Plastic and Reconstructive Surgery Physician, NPI 1821064288

MARTIN S LACEY (MD) is a healthcare provider. based in Bloomington, Minnesota. specializing in Plastic and Reconstructive Surgery Physician. They hold the professional credentials MD. They hold a License No. 44353 (MN). The NPI Number for MARTIN S LACEY (MD) is 1821064288

Main info

Male
44 Years Of Experience
Accepts Medicare Assignment
Name
MARTIN S LACEY (MD)
NPI
1821064288
Phone
(952) 883-5463
Address
8100 34TH AVE S
Enumeration Date
27 February 2006
Last Update Date
23 October 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6512912848
Graduation Year
1982 (44 years ago)
PAC ID
0345201182
Group Practice PAC ID
0547169211
Professional Enrollment ID
I20110118001342
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for MARTIN S LACEY (MD)

  • 34th Ave South, Bloomington, Hennepin County, Minnesota, 55450, United States

    MAIL STOP 21110Q

    BLOOMINGTON, MN 554251672

    Phone: (952) 883-5463

    Fax: (952) 883-5395

    Type: Mailing

  • Regions Hospital, 640, Jackson Street, Saint Paul, Ramsey County, Minnesota, 55101, United States

    MC 11503B

    SAINT PAUL, MN 551012502

    Phone: (651) 254-3792

    Fax: (651) 254-8208

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $120.

Total Amount is formed as General ($120) + Research ($0) + Ownership ($0) = $120.

Last reported payment date: 2024-04-30 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($120).

Total Amount

$120

General + Research + Ownership

Payments

1

Total payment records

General Amount

$120

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
DePuy Synthes Sales Inc.$120
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: 2011-01-18

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
I20110118001342IPlastic And Reconstructive 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.

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

Insurance plans in this area (ZIP 55425)

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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: 0547169211View full group profile
NameSpecialtyState
-MN
Physician AssistantMN
Orthopedic SurgeryMN
Nurse PractitionerMN
Nurse PractitionerMN
Certified Registered Nurse Anesthetist (Crna)MN
N E U R O L O G YMN
Nurse PractitionerMN
-MN
Physical Medicine And RehabilitationMN

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARTIN S LACEY (MD)?
MARTIN S LACEY (MD) — NPI 1821064288 — is the standard way to identify this listing.
Is MARTIN S LACEY (MD) still practicing?
MARTIN S LACEY (MD) is currently listed as active in the public NPI registry.
What is MARTIN S LACEY (MD) best known for clinically?
Directory data describes MARTIN S LACEY (MD) with Plastic and Reconstructive Surgery Physician. Clinical services aligned with this taxonomy classification.
Where should I expect MARTIN S LACEY (MD) on a map?
Expect Bloomington, Minnesota as a primary anchor for MARTIN S LACEY (MD) unless the record lists multiple sites.
Is the information about MARTIN S LACEY (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."