DR. CASSANDRA LYNNE STACY (D.M.D.) – Oral and Maxillofacial Surgery (Dentist), NPI 1033179577

DR. CASSANDRA LYNNE STACY (D.M.D.) is a healthcare provider. based in Woodbury, Minnesota. specializing in ORAL SURGERY. They hold the professional credentials D.M.D.. They hold a License No. D12052 (MN). The NPI Number for DR. CASSANDRA LYNNE STACY (D.M.D.) is 1033179577

Main info

Female
25 Years Of Experience
Name
DR. CASSANDRA LYNNE STACY (D.M.D.)
NPI
1033179577
Phone
(651) 578-7000
Address
9950 VALLEY CREEK RD
Enumeration Date
27 March 2006
Last Update Date
6 November 2024

Doctor Profile

Medical School Name
UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Secondary Phone
6514526933
Graduation Year
2001 (25 years ago)
PAC ID
9032151816
Group Practice PAC ID
9436127560
Professional Enrollment ID
I20050523001187
Address ID
MN551222486EA2130XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

81 ORAL SURGERY in MN

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Provider Addresses for DR. CASSANDRA LYNNE STACY (D.M.D.)

  • 9950, Valley Creek Road, Woodbury, Washington County, Minnesota, 55125, United States

    SUITE 100

    WOODBURY, MN 551254883

    Phone: (651) 578-7000

    Fax: (651) 773-9646

    Type: Mailing

  • 2130 CLIFF RD STE 100

    EAGAN, MN 551222486

    Phone: (651) 452-6933

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $316.

Total Amount is formed as General ($316) + Research ($0) + Ownership ($0) = $316.

Last reported payment date: 2024-01-18 • Largest payer in this snapshot: Straumann USA LLC ($175).

Total Amount

$316

General + Research + Ownership

Payments

4

Total payment records

General Amount

$316

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-05-23

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
I20050523001187IOral SurgeryMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99202New patient office or other outpatient visit, 15-29 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 55125)

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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: 9436127560View full group profile
NameSpecialtyState
Oral SurgeryMN
-MN
Maxillofacial SurgeryMN
Oral SurgeryMN
Oral Surgery, Maxillofacial SurgeryMN
Maxillofacial SurgeryMN

Reviews

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Frequently asked questions

How do payers reference DR. CASSANDRA LYNNE STACY (D.M.D.)?
For DR. CASSANDRA LYNNE STACY (D.M.D.), use NPI 1033179577 as the unique 10-digit identifier.
Is there an active status for DR. CASSANDRA LYNNE STACY (D.M.D.)?
For scheduling context, DR. CASSANDRA LYNNE STACY (D.M.D.) is shown as active in the registry.
What area of care is associated with DR. CASSANDRA LYNNE STACY (D.M.D.)?
DR. CASSANDRA LYNNE STACY (D.M.D.)'s record emphasizes Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
Is DR. CASSANDRA LYNNE STACY (D.M.D.) located near Woodbury?
DR. CASSANDRA LYNNE STACY (D.M.D.) currently maps to Woodbury, Minnesota in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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