Stacey L Ko, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9655 Issued in MN

Practice address

7500 80TH St S, Suite 100 - Ms 34624a
Healthpartners Cottage Grove Clinic
Cottage Grove, MN 55016-3008

Phone

(651) 415-4100

Fax

(651) 415-4101

NPI assigned

Mar 31, 2006

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

Other identifiers 1

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

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Allina United Hospital Hospital, Saint Paul, MN, CCN 240038

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

72.5

Promoting interoperability

100

Improvement activities

40

Cost

77.07

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sko42230@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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment
• Allina Health System

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1336185651
  NPD
• Allina Health System

  • Radiology Clinic/Center
  • Edina, MN
  • NPI 1871006700
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• Allina Health System

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1467758813
  NPD (past)

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

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Woodbury, MN
  • NPI 1063668937

  Hospital

  Care Compare affiliation
• Allina Health System

  • Neurological Surgery Physician
  • Minneapolis, MN
  • NPI 1144264540

  Hospital

  Care Compare affiliation
• Allina Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Paul, MN
  • NPI 1265474704

  Hospital

  Care Compare affiliation
• Allina Health System

  • Obstetrics & Gynecology Physician
  • Saint Paul, MN
  • NPI 1275789091

  Hospital

  Care Compare affiliation
• Allina Health System

  • Oncology Clinic/Center
  • Saint Paul, MN
  • NPI 1295182855

  Hospital

  Care Compare affiliation
• Allina Health System

  • Specialist
  • St Paul, MN
  • NPI 1447550702

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1457319485
  Care Compare affiliation
• Allina Health System

  • Orthopaedic Surgery Physician
  • Edina, MN
  • NPI 1508099656

  Hospital

  Care Compare affiliation
• Allina Health System

  • General Acute Care Hospital
  • Hastings, MN
  • NPI 1508457045
  Care Compare affiliation
• Allina Health System

  • Clinic/Center
  • St Paul, MN
  • NPI 1518173319

  Hospital

  Care Compare affiliation
• Allina Health System

  • Cardiovascular Disease Physician
  • Saint Paul, MN
  • NPI 1588929079

  Hospital

  Care Compare affiliation
• Allina Health System

  • Neurological Surgery Physician
  • Saint Paul, MN
  • NPI 1619914207

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1821059692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "651-415-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 80TH ST S, SUITE 100 - MS 34624A",
            "address_2": "HEALTHPARTNERS COTTAGE GROVE CLINIC",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550163008",
            "telephone_number": "651-415-4100",
            "fax_number": "651-415-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "STACEY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150112700",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sko42230@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "7500 80th St S, Suite 100 - MS 34624A",
            "address_2": "HealthPartners Cottage Grove Clinic",
            "city": "Cottage Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550163008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• King David Home Health Care Services
• King David Home Health Care Services LLC
• Taylor Kline, MS
• Kurtis A Klotzbuecher, DDS
• Alissa Marie Knoblach
• Michael P Koch, LIC SW
• Jacob S Kolosky, DPT
• Nathan Andrew Koppe, CNP
• Jennifer Korf, LMFT
• Kendra Krasin

• Physician Assistant in Cottage Grove, MN
• Providers in Cottage Grove, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.