DR. STACEY LYNN GUTMAN (M.D.) – Surgery Physician, NPI 1730447251
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
541 GENERAL SURGERY in KY
Provider Addresses for DR. STACEY LYNN GUTMAN (M.D.)
800 Rose Street
Lexington, KY 40536
Phone: (859) 323-6762
Fax: (759) 323-6840
Type: Location
24 Miles Center Way
Damariscotta, ME 045434067
Phone: (207) 563-4252
Type: Location
24 MILES CENTER WAY
DAMARISCOTTA, ME 045434067
Phone: (207) 563-4252
Fax: (759) 323-6840
Type: Mailing
512 SKYLINE BLVD STE 1
CLOQUET, MN 557201199
Phone: (218) 879-4641
Fax: (218) 878-7081
Type: Location
181 Franklin Health Commons
Farmington, ME 04938
Phone: (207) 778-6579
Fax: (207) 778-6409
Type: Location
800 ROSE STREET
LEXINGTON, KY 40536
Phone: (859) 323-6762
Fax: (759) 323-6840
Type: Mailing
181 FRANKLIN HEALTH COMMONS
FARMINGTON, ME 04938
Phone: (207) 778-6579
Fax: (207) 778-6409
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $12.
Total Amount is formed as General ($12) + Research ($0) + Ownership ($0) = $12.
Last reported payment date: 2024-11-12 • Largest payer in this snapshot: Kerecis Limited ($12).
Total Amount
$12
General + Research + Ownership
Payments
1
Total payment records
General Amount
$12
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kerecis Limited | $12 |
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: 2024-07-05
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240705001751 | I | General Surgery | MN | TBD |
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.
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 40536)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | MN | |
| Nurse Practitioner | MN | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| - | MN | |
| - | MN | |
| - | MN | |
| General Surgery | MN | |
| - | MN | |
| Certified Registered Nurse Anesthetist (Crna) | KY | |
| Internal Medicine, Hematology/Oncology | MN |
Reviews
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