NPIMap

Individual provider Active NPI

Stefany Nordby

  • Medical Physician Assistant
  • Elbow Lake, MN
National Provider Identifier
1043696420
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2311 Issued in MN
Practice address
1411 Highway 79 E
Elbow Lake, MN 56531-4645
Phone
(218) 685-7300
Fax
(218) 685-7296
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2311 MN Primary

Addresses

Primary practice location

1411 Highway 79 E
Elbow Lake, MN 56531-4645

Mailing address

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

Other identifiers 1

IdentifierTypeStateIssuer
2311OtherMNMN BOARD OF MEDICAL PRACTICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150925000028 MN Practitioner - Physician Assistant 4385952357 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1411 Hwy 79 E
Elbow Lake, MN 56531-4645
Phone (218) 685-7300

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.33 of 100Reported as group
Quality
93.68
Promoting interoperability
100
Improvement activities
40
Cost
70.75

Merit-based Incentive Payment System (MIPS)

Final score
88.64 of 100Reported as group
Quality
86.84
Promoting interoperability
100
Improvement activities
40
Cost
75.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2311MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Apr 15, 2016 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Aug 1, 2015 Accepting new patients
West Central Internal Medicine Past Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1043696420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S CASCADE ST",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372913",
            "telephone_number": "218-736-8000",
            "fax_number": "218-685-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 HIGHWAY 79 E",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "565314645",
            "telephone_number": "218-685-7300",
            "fax_number": "218-685-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDBY",
        "first_name": "STEFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "2311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF MEDICAL PRACTICE",
            "identifier": "2311",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elbow Lake, MN

Sources for this page

Verify at the official NPI Registry.