NPIMap

Individual provider Active NPI

Jessica Lynn Stay, MD

  • Family Medicine Physician
  • Bemidji, MN
National Provider Identifier
1124476049
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62728 Issued in MN
Practice address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone
(218) 333-5000
Fax
(218) 333-5360
NPI assigned
Jun 1, 2016
Last updated
Apr 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 62728 MN Primary

Addresses

Primary practice location

1300 Anne St NW
Bemidji, MN 56601-5103

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (218) 333-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstay13763679@direct.sanfordhealth.org

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
I20191022002029 MN Practitioner - Family Practice 8022301761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.56 of 100Reported as group
Quality
74.25
Promoting interoperability
100
Improvement activities
40
Cost
76.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota Family Medicine Current Accepting new patients
Sanford Health of Northern Minnesota Family Medicine CurrentSince Mar 23, 2020 Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Mar 23, 2020 Accepting new patients

Locations

1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

1705 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2035

1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481

Interoperability endpoints

  • Direct secure messaging: jstay13763679@direct.sanfordhealth.org

Organizations & group practices 3

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

Hospital & facility affiliations 6

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": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1124476049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "218-333-5000",
            "fax_number": "218-333-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015103",
            "telephone_number": "218-333-5000",
            "fax_number": "218-333-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAY",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "62728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstay13763679@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "1300 Anne St NW",
            "city": "Bemidji",
            "state": "MN",
            "country_code": "US",
            "postal_code": "566015103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

Verify at the official NPI Registry.