PAUL J LYSNE (MD) – Family Medicine Physician, NPI 1912971706

PAUL J LYSNE (MD) is a healthcare provider. based in Andover, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 36180 (MN). The NPI Number for PAUL J LYSNE (MD) is 1912971706

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
PAUL J LYSNE (MD)
NPI
1912971706
Phone
(763) 587-4600
Address
15245 BLUEBIRD ST NW
Enumeration Date
16 February 2006
Last Update Date
9 July 2013

Doctor Profile

Medical School Name
UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE
Secondary Phone
6512912848
Graduation Year
1989 (37 years ago)
PAC ID
6608830294
Group Practice PAC ID
1759293954
Professional Enrollment ID
I20041113000233
Address ID
MN551305302SA435XXBLVD300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,076 FAMILY PRACTICE in MN

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Provider Addresses for PAUL J LYSNE (MD)

  • 15245, Bluebird Street Northwest, Andover, Anoka County, Minnesota, 55304, United States

    ANDOVER, MN 553043554

    Phone: (763) 587-4600

    Fax: (763) 587-4615

    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)

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: 2004-11-13

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
I20041113000233IFamily PracticeMNTBD

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
36415Insertion of needle into vein for collection of blood sample404210$0
99214Established patient office or other outpatient visit, 30-39 minutes281207$0
85027Complete blood cell count (red cells, white blood cell, platelets), automated test177159$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit151151$0
99213Established patient office or other outpatient visit, 20-29 minutes8266$0
View full utilization report →

Insurance plans in this area (ZIP 55304)

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Provider's Procedures

PAUL J LYSNE (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMN85610Blood test, clotting time9313
FAMILY MEDICINEMN90670Pneumococcal vaccine for injection into muscle1515

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: 1759293954View full group profile

Reviews

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Frequently asked questions

What federal number belongs to PAUL J LYSNE (MD)?
The federal identifier for PAUL J LYSNE (MD) is NPI 1912971706.
Is PAUL J LYSNE (MD)'s NPI currently valid?
The extract we use shows PAUL J LYSNE (MD) as active.
What kind of provider is PAUL J LYSNE (MD)?
The page reflects Family Medicine Physician for PAUL J LYSNE (MD). Clinical services aligned with this taxonomy classification.
Where is PAUL J LYSNE (MD)'s primary listing?
We display Andover, Minnesota because that is what the record indicates for PAUL J LYSNE (MD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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