NPIMap

Individual provider Active NPI

Mollie A Stapleton, MD

  • Family Medicine Physician
  • Cloquet, MN
National Provider Identifier
1912961228
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41732 Issued in MN
Practice address
927 Trettel Lane
Fond Du Lac Human Services Division
Cloquet, MN 55720
Phone
(218) 879-1227
NPI assigned
Apr 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41732 MN Primary

Addresses

Primary practice location

927 Trettel Lane
Fond Du Lac Human Services Division
Cloquet, MN 55720

Mailing address

211 W 4TH St
Duluth, MN 55806-2719
Phone (218) 525-0557

Other identifiers 1

IdentifierTypeStateIssuer
383818800MedicaidMN

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
I20120124000196 MN Practitioner - Family Practice 5294902714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1998
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

927 Trettel LN
Cloquet, MN 55720-1345
Phone (218) 879-1227

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41732MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Hospital Association CurrentSince Nov 1, 2015 Accepting new patients
Fond Du Lac Reservation Business Committee CurrentSince Jan 6, 2003 Accepting new patients
Fond Du Lac Reservation Business Committee CurrentSince Jan 6, 2003 Accepting new patients
St. Luke's Hospital of Duluth Past Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

512 Skyline Blvd
Cloquet, MN 55720
Phone (218) 878-7207

417 Skyline Blvd
Cloquet, MN 55720
Phone (218) 879-1271

211 W 4th St
Duluth, MN 55806
Phone (218) 726-1370

221 W 4th St
Duluth, MN 55806
Phone (218) 279-4142

Interoperability endpoints

  • Direct secure messaging: mollie.stapleton.p1@direct.fonddulachsd.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1912961228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W 4TH ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558062719",
            "telephone_number": "218-525-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 TRETTEL LANE",
            "address_2": "FOND DU LAC HUMAN SERVICES DIVISION",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "55720",
            "telephone_number": "218-879-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "MOLLIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "41732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383818800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

Verify at the official NPI Registry.