Stephanie W Putzier, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35972 Issued in MN

Practice address

3530 Lexington Ave N
Shoreview, MN 55126-8166

Phone

(651) 714-0200

Fax

(651) 714-0201

NPI assigned

Jan 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1275512261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 COUNTRY CLUB DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560019338",
            "telephone_number": "507-380-3644",
            "fax_number": "507-345-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 LEXINGTON AVE N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268166",
            "telephone_number": "651-714-0200",
            "fax_number": "651-714-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTZIER",
        "first_name": "STEPHANIE",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "35972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAS PPO",
            "identifier": "1966132",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "958583400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0401916",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "121151",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP25864",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "410849339 56001 C077",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA2951023855",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110103558",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1M944PU",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.