NPIMap

Individual provider Active NPI

Meryl Stafford, PA-C

  • Physician Assistant
  • Roseville, MN
National Provider Identifier
1821477233
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11855 Issued in MN
Practice address
2355 Hwy 36 W.
Ste. 100
Roseville, MN 55113-3905
Phone
(651) 292-2000
NPI assigned
May 19, 2015
Last updated
Jul 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11855 MN Primary

Addresses

Primary practice location

2355 Hwy 36 W.
Ste. 100
Roseville, MN 55113-3905

Mailing address

2355 Hwy 36 W.
Ste. 100
Roseville, MN 55113-3905
Phone (651) 292-2000

Other practice location 1

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Other practice location 2

250 Thompson St.
St. Paul, MN 55102
Phone (651) 292-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150618001116 MN Practitioner - Physician Assistant 8729399696 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 292-2000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (651) 292-2000

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

Merit-based Incentive Payment System (MIPS)

Final score
93.17 of 100Reported as group
Quality
95
Improvement activities
40
Cost
82.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2269MNMDCertified Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lac Qui Parle Clinic of Madison Inc Current Accepting new patients
Fairview Clinics CurrentSince Apr 6, 2021 Accepting new patients
Fairview Clinics CurrentSince Apr 6, 2021 Accepting new patients
Allina Health System CurrentSince Aug 1, 2015 Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 1, 2018 Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 1, 2018 Accepting new patients
Fairview Health Services CurrentSince Aug 8, 2016 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Aug 8, 2016 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Allina Health System CurrentSince Aug 1, 2015 Accepting new patients
Fairview Health Services Past Accepting new patients
Consulting Radiologists, LTD Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

6405 France Ave S
Ste 440
Edina, MN 55435
Phone (952) 927-7004

820 3rd Ave
Madison, MN 56256
Phone (320) 598-3552

900 2nd Ave
Madison, MN 56256
Phone (320) 598-7536

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

6525 France Ave S
Ste 200
Minneapolis, MN 55435
Phone (952) 848-8890

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: mstafford345794@fairview.direct-ci.com

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1821477233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W.",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W.",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Fulton St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554554800",
            "country_code": "US",
            "telephone_number": "612-672-7422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Thompson St.",
            "address_purpose": "LOCATION",
            "city": "St. Paul",
            "state": "MN",
            "postal_code": "55102",
            "country_code": "US",
            "telephone_number": "651-292-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "MERYL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.