Individual provider Active NPI

Teresa Rae Cyrus, DNP, FNP-C

  • Family Nurse Practitioner
  • Stillwater, MN
National Provider Identifier
1659763928
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3692 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
Feb 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3692 MN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3692 MN

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

  • Teresa Rae Moore Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150402002249 MN Practitioner - Nurse Practitioner 7719204684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3692MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Illumia Health LLC CurrentSince May 1, 2025 Accepting new patients

Locations

3580 Linden Ave
Ste A1
White Bear Lk, MN 55110
Phone (651) 633-6522

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1659763928",
    "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": "CYRUS",
        "first_name": "TERESA",
        "middle_name": "RAE",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-24",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "3692",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "3692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MOORE",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.