Stacie Bistodeau

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7513 Issued in MN

Practice address

18465 Orchard TRL Ste 200
Lakeville, MN 55044-2525

Phone

(952) 428-0950

NPI assigned

Jul 26, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sasaki Medical LLCGroup PAC ID 3779879903, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: staciebistodeau@excellian.direct.allina.com

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.

• Sasaki Medical LLC

  dba Kai Shin Clinic

  • Addiction Medicine (Family Medicine) Physician
  • Roseville, MN
  • NPI 1326490475
  Medicare reassignment Care Compare group NPD
• Sasaki Medical LLC

  dba Kai Shin Reference Lab

  • Clinical Medical Laboratory
  • Saint Paul, MN
  • NPI 1992472757
  NPD
• Southside Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1538137757
  NPD
• Southside Community Health Services, Inc.

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1679690952
  NPD
• Sasaki Medical LLC

  dba Kai Shin Clinic

  • Addiction Medicine (Family Medicine) Physician
  • Saint Paul, MN
  • NPI 1043829625
  NPD (past)

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

{
    "created_epoch": "1595721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1740899756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18465 ORCHARD TRL STE 200",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550442525",
            "telephone_number": "952-428-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15251 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Center City",
            "state": "MN",
            "postal_code": "550129640",
            "country_code": "US",
            "telephone_number": "800-257-7800",
            "fax_number": "651-213-4547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISTODEAU",
        "first_name": "STACIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-26",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "7513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "staciebistodeau@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "18465 Orchard Trl Ste 200",
            "city": "Lakeville",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550442525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Manika Bhateja, M.D
• Claire Gabriel Bias
• Melissa Bielefeld, LGSW, MSW
• Bio-Medical Applications of Minnesota, Inc. (Fresenius Medical Care Lakeville)
• Erin Bird, LMFT
• Sally Bittar
• Caleb J Blank, DC
• Kyle Blom, LMT
• Linnea Marie Bodenhamer, MA
• Anna Boeser

• Family Nurse Practitioner in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.