Sage Prairie Laboratory
NPI 1164089447ActiveOrganization· Specialist/Technologist, Other· Eagan, MN
Specialist/Technologist, Other in Eagan, Minnesota, registered in NPPES in May 2019, part of Medical Addiction Treatment Clinic. The authorized official on file is Grant Arnold Pylkas, MMA, Executive Director.
Overview
| NPI | 1164089447 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Medical Addiction Treatment Clinic |
| NPI issued | May 22, 2019 |
| Last updated in NPPES | May 22, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist/Technologist, Other Primary | 246Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|