EZRA LYON (M.D.) – Family Medicine Physician, NPI 1669906004
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,050 FAMILY PRACTICE in WI
Provider Addresses for EZRA LYON (M.D.)
Neenah Center, Menasha, Winnebago County, Wisconsin, 54956, United States
NEENAH, WI 549563070
Phone: (715) 256-3000
Fax: (715) 256-3079
Type: Mailing
1102 S Park St
Madison, WI 537151708
Phone: (608) 263-3111
Type: Location
800 Riverside Dr
Waupaca, WI 549811943
Phone: (715) 258-1000
Type: Location
710, Riverside Drive, Waupaca, Waupaca County, Wisconsin, 54981, United States
WAUPACA, WI 549811941
Phone: (715) 256-3000
Fax: (715) 256-3079
Type: Location
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: 2020-09-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200921000050 | I | Family Practice | WI | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 139 | 95 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 57 | 57 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 51 | 25 | $0 |
| G0008 | Administration of influenza virus vaccine | 22 | 21 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 20 | 19 | $0 |
Insurance plans in this area (ZIP 54956)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | WI | |
| Clinical Psychologist | IL | |
| Mental Health Counselor | WI | |
| Mental Health Counselor | WI | |
| Physician Assistant | WI | |
| Mental Health Counselor | WI | |
| - | WI | |
| Nurse Practitioner | WI | |
| Mental Health Counselor | WI |
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