Stacey Lynn Gutman, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

77119 Issued in MN

Practice address

512 Skyline Blvd Ste 1
Cloquet, MN 55720-1199

Phone

(218) 879-4641

Fax

(218) 878-7081

NPI assigned

May 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Kentucky College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Memorial Hospital AssociationGroup PAC ID 0042129991, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Memorial Hospital Hospital, Cloquet, MN, CCN 241364

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stacey.gutman.1@8356.direct.athenahealth.com
• Direct secure messaging: sgutman239902@direct.mmc.mainehealth.org

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.

• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Medicare reassignment Care Compare group NPD
• Calais Community Hospital

  • Critical Access Hospital
  • Calais, ME
  • NPI 1922001049
  NPD
• Mainehealth

  dba Mainehealth Behavioral Health

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  NPD
• Community Memorial Hospital Association

  • Dialysis Equipment & Supplies (DME)
  • Cloquet, MN
  • NPI 1528103652
  NPD (past)

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

• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Care Compare affiliation

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1730447251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MILES CENTER WAY",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "045434067",
            "telephone_number": "207-563-4252",
            "fax_number": "759-323-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 SKYLINE BLVD STE 1",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201199",
            "telephone_number": "218-879-4641",
            "fax_number": "218-878-7081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Franklin Health Commons",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "ME",
            "postal_code": "04938",
            "country_code": "US",
            "telephone_number": "207-778-6579",
            "fax_number": "207-778-6409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Rose Street",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-323-6762",
            "fax_number": "759-323-6840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Miles Center Way",
            "address_purpose": "LOCATION",
            "city": "Damariscotta",
            "state": "ME",
            "postal_code": "045434067",
            "country_code": "US",
            "telephone_number": "207-563-4252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "R2933",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD21753",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "77119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa J Gotchnik, RPH
• Malique D Goulet
• Graceful Strides Wellness Center LLC
• Dayna Marie Grimm, CHW
• John Anthony Gust, RPH
• Jennifer Susan Hall, RD, LD
• Farrah Halvorson
• Alan Daniel Haney, MSW, LICSW
• Bobbijo Ellen Hanson, RN
• Jessica Lynn Hanson

• Surgery Physician in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.