Stacy Reller, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

CNP 4769 Issued in MN

Practice address

2530 Chicago Ave Ste 400
Minneapolis, MN 55404

Phone

(612) 813-3300

Fax

(612) 813-3349

NPI assigned

Sep 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Children'S Respiratory and Critical Care Specialists PAGroup PAC ID 8022084235, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Children'S Respiratory & Critical Care Specialists. P.a.

  • Pediatric Pulmonology Physician
  • Minneapolis, MN
  • NPI 1003816505
  Medicare reassignment Care Compare group
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880
  NPD (past)

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1659820264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044387",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CHICAGO AVE STE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55404",
            "telephone_number": "612-813-3300",
            "fax_number": "612-813-3349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 Chicago Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "612-813-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Chicago Ave S",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "612-813-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RELLER",
        "first_name": "STACY",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MN",
            "license": "CNP 4769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Critical Care Pediatric Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Critical Care Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.