Kersten Paul Stalnaker, PSYD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6337 Issued in MN

Practice address

210 9TH St SE
Rochester, MN 55904

Phone

(507) 288-3443

NPI assigned

Oct 10, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Olmsted Medical CenterGroup PAC ID 8527970060, 324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Olmsted Medical Center Hospital, Rochester, MN, CCN 240006

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Olmsted Medical Center

  • Clinic/Center
  • Rochester, MN
  • NPI 1952356297
  Medicare reassignment Care Compare group NPD
• Olmsted Medical Center

  • General Acute Care Hospital
  • Rochester, MN
  • NPI 1538112131
  NPD

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1164706008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046756",
            "telephone_number": "507-288-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55904",
            "telephone_number": "507-288-3443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 4th St SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559044717",
            "country_code": "US",
            "telephone_number": "507-529-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 9th St SE",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559046756",
            "country_code": "US",
            "telephone_number": "507-288-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALNAKER",
        "first_name": "KERSTEN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-10",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elaine Stageberg, MD, MHA
• Jean Stahl, APRN
• Gina Marie Stalboerger, OD
• Chrystal Rose Stallworth, MD
• Erica Dawn Stalnaker, NP
• Siennah Stamness, DPT
• Daniela L Stan, MD
• Marius N Stan, M.D.
• Jaime Victoria Stanczyk
• Heather Standorf

• Psychologist in Rochester, MN
• Providers in Rochester, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.