Stacy Pirruccello, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3587 Issued in MN

Practice address

13195 Weaver Lake Rd
Maple Grove, MN 55369-9410

Phone

(763) 420-5112

NPI assigned

Jul 24, 2018

Last updated

Jun 22, 2026By the provider in NPPES

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Brokea Inc.Group PAC ID 9537328075, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brokea Inc.

  dba Pearle Vision

  • Optometrist
  • Maple Grove, MN
  • NPI 1346453735
  Medicare reassignment Care Compare group NPD
• DJ-MN Inc

  dba Select Eyecare

  • Optician
  • Anoka, MN
  • NPI 1205988805
  Medicare reassignment NPD
• DJ-MN Inc

  dba Select Eyecare

  • Optician
  • Coon Rapids, MN
  • NPI 1578615019
  NPD

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1780161539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112",
            "fax_number": "763-420-6957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13195 WEAVER LAKE RD",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553699410",
            "telephone_number": "763-420-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIRRUCCELLO",
        "first_name": "STACY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Pietsch
• Piic Clinical Services (Boston Scientific Occupation Health Center - Maple Grove)
• Thomas John Pink, DDS
• Pipe Trade Healthcare Services
• Gregory C Pippert, MD
• Andrew John Barran Pisansky, MD, MS
• Corey Pisk, PHARM.D.
• Plateau Healthcare Maple Grove LLC (PHC Maple Grove)
• Platinum Health, LLC
• Erin Ann Plourde, PA-C

• Optometrist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.