NPIMap

Individual provider Active NPI

Sara Joan Jennisch, MSN, CNP, AGNP-C

  • Gerontology Nurse Practitioner
  • Stillwater, MN
National Provider Identifier
1548028053
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11376 Issued in MN
Practice address
270 Main St N Ste 300
Stillwater, MN 55082-6788
Phone
(651) 342-1039
Fax
(651) 342-1428
NPI assigned
Mar 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11376 MN
Primary Care Nurse Practitioner 363LP2300X 11376 MN
Gerontology Nurse Practitioner 363LG0600X 11376 MN Primary

Addresses

Primary practice location

270 Main St N Ste 300
Stillwater, MN 55082-6788

Mailing address

270 Main St N Ste 300
Stillwater, MN 55082-6788
Phone (651) 342-1039

Other names 1

  • Sara J Pearson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240325000110 MN Practitioner - Nurse Practitioner 8921445131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluestone Physician Services PAGroup PAC ID 4486658333, 61 clinicians

Practice addresses (Care Compare)

270 Main St N
Suite 300
Stillwater, MN 55082-6788
Phone (651) 342-1039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11376MNMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bluestone Physician Services, P.a. CurrentSince Apr 15, 2024 Accepting new patients

Locations

270 Main St N
Ste 300
Stillwater, MN 55082
Phone (651) 342-1039

Organizations & group practices 1

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1548028053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 MAIN ST N STE 300",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826788",
            "telephone_number": "651-342-1039",
            "fax_number": "651-342-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 MAIN ST N STE 300",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826788",
            "telephone_number": "651-342-1039",
            "fax_number": "651-342-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNISCH",
        "first_name": "SARA",
        "middle_name": "JOAN",
        "credential": "MSN, CNP, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "11376",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MN",
            "license": "11376",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "11376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "PEARSON",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.