Stacy Ryan Johnson, BS in Eden Prairie, MN - Medicare Counselor Provider

Stacy Ryan Johnson, BS is a medicare enrolled "Counselor - Mental Health" provider in Eden Prairie, Minnesota. His current practice location is 7527 Mitchell Road, 100, Eden Prairie, Minnesota. You can reach out to his office (for appointments etc.) via phone at (952) 228-2282.

Stacy Ryan Johnson is licensed to practice in Minnesota (license number 2290) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1588844898.

Contact Information

	Stacy Ryan Johnson, BS
	7527 Mitchell Road, 100, Eden Prairie, MN 55344
	(952) 228-2282
	(952) 224-2284

Map and Direction

Healthcare Provider's Profile

Full Name	Stacy Ryan Johnson
Gender	Male
Speciality	Counselor - Mental Health
Location	7527 Mitchell Road, Eden Prairie, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588844898
Provider Enumeration Date: 11/05/2007
Last Update Date: 04/25/2024

Medicare PECOS Information:

PECOS PAC ID: 9234570672
Enrollment ID: I20240515004283

Medical Identifiers

Medical identifiers for Stacy Ryan Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588844898	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	2290 (Minnesota)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stacy Ryan Johnson allows following entities to bill medicare on his behalf.

Entity Name	Family Innovations Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992862783 PECOS PAC ID: 6204178528 Enrollment ID: O20190506002814

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy Ryan Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Stacy Ryan Johnson, BS 2115 County Road D E, Suite B, Maplewood, MN 55109-5353 Ph: (651) 748-5019	Stacy Ryan Johnson, BS 7527 Mitchell Road, 100, Eden Prairie, MN 55344 Ph: (952) 228-2282

Reviews and Comments

Counselor in Eden Prairie, MN

Aaron Leander Grier, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7525 Mitchell Rd, Eden Prairie, MN 55344 Phone: 952-224-2282 Fax: 952-224-2284
Peter Joseph Dorsen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14377 Chestnut Drive, Eden Prairie, MN 55347 Phone: 612-226-3106
Mr. Richard Arthur Rittmaster, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 11010 Prairie Lakes Dr, Suite 350, Eden Prairie, MN 55344 Phone: 952-746-2522 Fax: 952-746-0887
Toby Dennert, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7525 Mitchell Rd, Suite 100, Eden Prairie, MN 55344 Phone: 952-224-2282
Claire Rosen, MA, LPCC, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 800 Prairie Center Dr Ste 210, Eden Prairie, MN 55344 Phone: 952-234-9210
Mrs. Susan Elizabeth Zaugg, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344 Phone: 952-746-2522
Josi Wylynn Carter, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11010 Prairie Lakes Dr Ste 350, Eden Prairie, MN 55344 Phone: 952-746-2522

Stacy Ryan Johnson, BS - Medicare Counselor in Eden Prairie, MN