Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Nicholas Lange, MD

Individual provider Military Health Care Provider · NPI 1285650952

Dr. Nicholas Lange, MD is a Diagnostic Radiology in Roseville, Minnesota. Graduated from New York University School of Medicine in 2004, 22 years ago. Practices with Fairview Clinics, a 806-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Virginia.

Years since qualifying
22
Trained at
New York University School of Medicine
Licensed in
MN, VA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905
Phone: (651) 292-0000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 250 Thompson St., St. Paul, MN 55102 — (651) 292-2000

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 65880 (MN)
Military Health Care Provider Taxonomy 171000000X · Licence 0101239993 (VA)

Record details

NPI number1285650952
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 14, 2006
Last updated in NPPESJuly 19, 2021
Certification dateJuly 19, 2021
Mailing address2355 Highway 36 W Ste 100, Roseville, MN 55113-3905

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Fairview Clinics — 806 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations26 on file with Medicare