Stacy Marie Anderson, PA-C
Individual provider Active NPI Physician Assistant · Savage, MN
NPI 1497933170 · NPPES record last updated Nov 4, 2020
Key facts
- NPI
- 1497933170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 6350 W 143Rd St Ste 102
Savage, MN 55378-2890 - Phone
- (952) 428-0200
- NPI assigned
- Feb 5, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Allina Health System
Practice addresses (Care Compare)
1455 Saint Francis Ave
Shakopee, MN 55379-3374
Phone (651) 635-9173
2925 Chicago Ave
Minneapolis, MN 55407-1321
440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225
6350 W 143Rd St
Savage, MN 55378-2890
Hospital & facility affiliations
- St Francis Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080328000677 | MN | Practitioner - Physician Assistant | 0840376984 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Locations
440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225
755 Crossroads Campus Dr NE
Buffalo, MN 55313
Phone (763) 684-6300
14000 Nicollet Ave
Ste 100
Burnsville, MN 55337
Phone (950) 985-8275
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
7373 France Ave S
Ste 202
Minneapolis, MN 55435
Phone (952) 835-1311
6350 W 143rd St
Ste 102
Savage, MN 55378
Phone (952) 428-1000
5565 Blaine Ave
South St Paul, MN 55076
Phone (651) 241-9400
8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000
Interoperability endpoints
- sanderson105252@excellian.direct.allina.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
6350 W 143Rd St Ste 102
Savage, MN 55378-2890
Mailing address
6350 W 143Rd St Ste 102
Savage, MN 55378-2890
Phone (952) 428-0200
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sanderson105252@excellian.direct.allina.com | Direct |
Other providers in Savage, MN
- Brynne Ambroz
- David Lowell Anderson
- Garrett Anderson
- Hillary Anderson
- Lexis Anderson
- Tait Anderson
- Tara Anderson
- Angel Ride LLC
- Fabio Anifrani
- Mindy Leigh Antiel
All providers in Savage, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.