Stephanie June Mysicka, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9365 Issued in WI

Practice address

235 E State St
Saint Croix Falls, WI 54024-4117

Phone

(715) 483-3221

Fax

(715) 483-0507

NPI assigned

Jul 9, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Society - Home Care Home health agency, St Croix Falls, WI, CCN 527309
• St Croix Regional Medical Center Hospital, Saint Croix Falls, WI, CCN 521337

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smysicka377330@excellian.direct.allina.com

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.

• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922

  MN

  Medicare reassignment Care Compare group NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Saint Croix Falls, WI
  • NPI 1669988861
  NPD (past)
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Frederic, WI
  • NPI 1811256126
  NPD (past)
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Webster, WI
  • NPI 1851652374
  NPD (past)

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

• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Care Compare affiliation
• The Evangelical Lutheran Good Samaritan Society

  • Home Health Agency
  • Saint Croix Falls, WI
  • NPI 1568627156
  Care Compare affiliation

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1427600584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYSICKA",
        "first_name": "STEPHANIE",
        "middle_name": "JUNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smysicka377330@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "235 E State St",
            "city": "Saint Croix Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540244117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelli McLey, CRNA
• Alaura Meister, PHARMD
• Hollie Lynn Miller, RN
• Rene Brian Milner, M.D.
• Ashlyn Andrea Mortel, RDH
• Vittal Ramachandra Nagar, M.D
• Cynthia Nelson
• Bradley G Nevins, PHD
• Glenn A Nickele, MD
• Mollisa A Noel, DPT

• Family Nurse Practitioner in Saint Croix Falls, WI
• Providers in Saint Croix Falls, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.