Individual provider Active NPI

Melissa Johnson Kriscunas, DO

  • Obstetrics & Gynecology Physician
  • Stillwater, MN
National Provider Identifier
1578735262
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
54948 Issued in MN
Practice address
921 Greeley St S
Stillwater, MN 55082-5935
Phone
(651) 439-1234
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 54948 MN Primary

Addresses

Primary practice location

921 Greeley St S
Stillwater, MN 55082-5935

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other practice location 1

1430 Highway 96 E
White Bear Lake, MN 55110-3653
Phone (651) 653-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120918000658 MN Practitioner - Obstetrics/Gynecology 3577711431 Reassigns benefits to 1 organization
I20240101000164 WI Practitioner - Obstetrics/Gynecology 3577711431 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
Westfields Hospital IncGroup PAC ID 2264490960, 108 clinicians

Practice addresses (Care Compare)

1430 Hwy 96 E
White Bear Lake, MN 55110-3653
Phone (651) 426-1980

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

Hospital & facility affiliations

  • Westfields Hospital and Clinic Hospital, New Richmond, WI, CCN 521345
  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
54948MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westfields Hospital, Inc CurrentSince Jun 1, 2025 Accepting new patients
Group Health, Inc. CurrentSince Aug 24, 2015 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Group Health Plan Inc CurrentSince Aug 24, 2015 Accepting new patients
Group Health, Inc. CurrentSince Feb 11, 2024 Accepting new patients
Lakeview Memorial Hospital Association Inc Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

8170 33rd Ave S
Stop 21110Q
Minneapolis, MN 55425

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
West Lakeland, MN 55082

1430 Highway 96 E
White Bear Lake, MN 55110
Phone (651) 426-9502

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

Interoperability endpoints

  • Direct secure messaging: mkriscunas43047@direct.healthpartners.com

Organizations & group practices 6

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 3

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1578735262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 GREELEY ST S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825935",
            "telephone_number": "651-439-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1430 Highway 96 E",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551103653",
            "country_code": "US",
            "telephone_number": "651-653-2100",
            "fax_number": "651-653-2125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISCUNAS",
        "first_name": "MELISSA",
        "middle_name": "JOHNSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "54948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.