STACI RAE KLOSTER (RDN) – Registered Dietitian, NPI 1174252779

STACI RAE KLOSTER (RDN) is a healthcare provider. based in Eagle river, Alaska. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RDN. They hold a License No. 196197 (AK). The NPI Number for STACI RAE KLOSTER (RDN) is 1174252779

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
STACI RAE KLOSTER (RDN)
NPI
1174252779
Phone
(907) 903-3707
Address
20615 EAGLE RIVER RD
Enumeration Date
8 June 2022
Last Update Date
8 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9077702380
Graduation Year
2019 (7 years ago)
PAC ID
4981087871
Group Practice PAC ID
0042505018
Professional Enrollment ID
I20221013003136
Address ID
AK995035769AN3909XBLVD301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

38 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in AK

Provider Addresses for STACI RAE KLOSTER (RDN)

  • 20615 EAGLE RIVER RD

    EAGLE RIVER, AK 995778748

    Phone: (907) 903-3707

    Type: Mailing

  • 3909 ARCTIC BLVD STE 101

    ANCHORAGE, AK 995035769

    Phone: (907) 644-8446

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221013003136IRegistered Dietitian Or Nutrition ProfessionalAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99577)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042505018View full group profile
NameSpecialtyState
Physician AssistantWA
Registered Dietitian Or Nutrition ProfessionalAK
General SurgeryAK
Physician AssistantAK
Clinical PsychologistAK
Clinical Social WorkerAK
General SurgeryGA
Clinical PsychologistOR
Registered Dietitian Or Nutrition ProfessionalAK
Physician AssistantAK

Reviews

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Frequently asked questions

How do payers reference STACI RAE KLOSTER (RDN)?
For STACI RAE KLOSTER (RDN), use NPI 1174252779 as the unique 10-digit identifier.
Active or inactive — what applies to STACI RAE KLOSTER (RDN)?
You should see STACI RAE KLOSTER (RDN) as active in CMS-hosted NPPES data.
What expertise is attributed to STACI RAE KLOSTER (RDN)?
STACI RAE KLOSTER (RDN)'s specialty line reads Registered Dietitian. Clinical services aligned with this taxonomy classification.
Where in Alaska is STACI RAE KLOSTER (RDN) registered?
Use Eagle River, Alaska as the headline location for STACI RAE KLOSTER (RDN) here.
When was this NPI issued?
Enumeration for STACI RAE KLOSTER (RDN) is noted as June 8, 2022 where the registry provides it.

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