Individual provider Active NPI

Natalie Elizabeth Stoltman, MD

  • Family Medicine Physician
  • Waconia, MN
National Provider Identifier
1619474673
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68467 Issued in MN
Practice address
424 W State Highway 5
Waconia, MN 55387-1795
Phone
(952) 442-4461
NPI assigned
Apr 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 68467 MN Primary

Addresses

Primary practice location

424 W State Highway 5
Waconia, MN 55387-1795

Mailing address

424 W State Highway 5
Waconia, MN 55387-1795
Phone (952) 442-4461

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL unknown
CONNECT URL unknown

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210126002851 MN Practitioner - Family PracticePractitioner - Obstetrics/GynecologyPractitioner - Emergency Medicine 6002166998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Clinic, LTD.Group PAC ID 6002801453, 52 clinicians

Practice addresses (Care Compare)

424 W State Hwy 5
Waconia, MN 55387-1723
Phone (952) 442-4461

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68467MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Clinic, LTD. CurrentSince Jul 30, 2021 Accepting new patients
CCM Health Current Accepting new patients
Ridgeview Medical Center Family Medicine Past Accepting new patients

Locations

110105 Pioneer Trl W
#100
Chaska, MN 55318
Phone (952) 556-0120

110105 Pioneer Trl W
Chaska, MN 55318
Phone (952) 361-5800

406 Faxon Rd N
Nya, MN 55368
Phone (952) 467-1915

424 W State Highway 5
Waconia, MN 55387
Phone (952) 442-4461

313 Territorial St E
Watertown, MN 55388
Phone (952) 442-4461

Interoperability endpoints

  • Direct secure messaging: nataliestoltman@tv.allscriptsdirect.net

Organizations & group practices 3

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 2

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": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1619474673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W STATE HIGHWAY 5",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871795",
            "telephone_number": "952-442-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLTMAN",
        "first_name": "NATALIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "68467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "address_1": "701 Park Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554151623",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unknown",
            "affiliation": "N",
            "address_1": "701 Park Ave",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554151623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.