Individual provider

Ezra Lyon, M.D.

Family Medicine Physician Obstetrics Physician Medicare enrolled

Ezra Lyon, M.D. is a Family Medicine Physician in Waupaca, WI, registered under NPI 1669906004. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 710 RIVERSIDE DR, Waupaca, WI 54981. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

710 RIVERSIDE DR, Waupaca, WI 54981 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
69896 WI Family Medicine Physician primary
69896 WI Obstetrics Physician

This provider holds licence 69896 issued in WI. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Family Practice
PAC ID
0547530388
Enrollment ID
I20200921000050

Medicare enrolment is recorded as approved under the provider type Practitioner - Family Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Family Medicine covers

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NUCC Health Care Provider Taxonomy, code 207Q00000X
Allopathic & Osteopathic Physicians Family Medicine

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
207Q00000X Family Medicine Physician 69896 WI primary
207VX0000X Obstetrics Physician Obstetrics 69896 WI

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1669906004 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateApr 12, 2017
Last updatedFeb 11, 2025
StatusActive
Sole proprietorNo
CredentialM.D.
Practice address 710 RIVERSIDE DR
Waupaca, WI 54981
(715) 256-3000
Fax (715) 256-3079
Mailing address 3 NEENAH CTR
Neenah, WI 54956
This record was updated on Feb 11, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1669906004 passes the NPI check digit test The final digit 4 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 6 6 9 9 0 6 0 0
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 6 3 9 9 0 3 0 0

Sum = 56 · next multiple of 10 = 60 · check digit = 4 · actual last digit = 4

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1669906004?
NPI 1669906004 is the National Provider Identifier assigned to Ezra Lyon, M.D. in Waupaca, WI. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Family Medicine Physician cover?
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
How do I contact Ezra Lyon, M.D.?
The phone number on file with NPPES is (715) 256-3000, last updated Feb 11, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Ezra Lyon, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1669906004 a valid number?
Yes. 1669906004 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.