Stephanie L Bantell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

57440-20 Issued in WI

Practice address

610 W Adams St
Black River Falls, WI 54615

Phone

(715) 284-4311

Fax

(715) 284-0475

NPI assigned

Oct 25, 2011

Last updated

Jun 30, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Black River Health IncGroup PAC ID 3173431178, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Croix Hospice Eau Claire Hospice, Eau Claire, WI, CCN 521599
• Black River Memorial Hospital Hospital, Black River Falls, WI, CCN 521333
• Pine View Care Center Nursing home, Black River Falls, WI, CCN 525409

Merit-based Incentive Payment System (MIPS)

Final score

89.18 of 100Reported as group

Quality

87.29

Promoting interoperability

100

Improvement activities

40

Cost

65.34

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/7b17929a-d976-4002-b080-2a37b05f2444/
• FHIR API: https://fhir4.healow.com/fhir/r4/BHJBDA
• Direct secure messaging: stephanie.bantell@kcld.eclinicaldirectplus.com

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.

• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Medicare reassignment Care Compare group NPD
• Krohn Clinic LTD.

  • Family Medicine Physician
  • Black River Falls, WI
  • NPI 1790777621
  Medicare reassignment NPD
• Black River Health Inc

  dba Black River Healthcare Clinic

  • Rural Health Clinic/Center
  • Black River Falls, WI
  • NPI 1255183182
  NPD
• Black River Memorial Hospital Inc

  • Community Based Hospice Care Agency
  • Black River Falls, WI
  • NPI 1063516078

  Family Medicine

  NPD

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

• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Care Compare affiliation
• Jackson Pine View Healthcare, LLC

  dba Pine View Nursing Home

  • Skilled Nursing Facility
  • Black River Falls, WI
  • NPI 1831209709

  Nursing home

  Care Compare affiliation
• St Croix Hospice LLC

  dba St. Croix Hospice

  • Community Based Hospice Care Agency
  • Eau Claire, WI
  • NPI 1841601952
  Care Compare affiliation

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1225314131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159110",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "54615",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-0475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W Adams St",
            "address_purpose": "LOCATION",
            "city": "Black River Falls",
            "state": "WI",
            "postal_code": "546155052",
            "country_code": "US",
            "telephone_number": "715-284-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANTELL",
        "first_name": "STEPHANIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "57440-20",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": "3928-850",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "57440-20",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "41109",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEP",
            "identifier": "3928-850",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA STATE BOARD",
            "identifier": "41109",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "57440-20",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darrin Antonelli, M.D.
• Stacy L. Armitage, OCCUPATIONAL THERAPI
• Art of Optometry LTD
• Justin Dean Atherton, O.D.
• Wendy M Backaus, RDN
• Emily Ruth Bartels
• Trevor Bauer, PHARMD
• Douglas Paul Beaver, PHARMD.
• Kristin Berg, RN
• Fawnah W Bish, RN

• Family Medicine Physician in Black River Falls, WI
• Providers in Black River Falls, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.