Stacie Bistodeau, is a medicare enrolled "Nurse Practitioner - Family" in Center City, Minnesota. Her current practice location is
15251 Pleasant Valley Rd, Center City, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(800) 257-7800.
Stacie Bistodeau is licensed to practice in Minnesota (license number 7513) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1740899756.
Provider's Profile
| Full Name | Stacie Bistodeau |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 15251 Pleasant Valley Rd, Center City, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1740899756
- Provider Enumeration Date: 07/26/2020
- Last Update Date: 07/26/2020
Medicare PECOS Information:
- PECOS PAC ID: 5597137711
- Enrollment ID: I20230215002219
Medical Identifiers
Medical identifiers for Stacie Bistodeau such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1740899756 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 7513 (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. Stacie Bistodeau allows following entities to bill medicare on her behalf.
| Entity Name | Southside Community Health Services Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538137757
PECOS PAC ID: 8921027228
Enrollment ID: O20051116000311 |
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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. Stacie Bistodeau 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 |
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Stacie Bistodeau,
15251 Pleasant Valley Rd,
Center City, MN 55012-9640
Ph: (800) 257-7800 | Stacie Bistodeau,
15251 Pleasant Valley Rd,
Center City, MN 55012-9640
Ph: (800) 257-7800 |
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