STACEY MIRON – Physical Therapist, NPI 1205365707
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,108 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN
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Provider Addresses for STACEY MIRON
15250, Homestead Avenue North, Hugo, Washington County, Minnesota, 55038, United States
HUGO, MN 550389408
Phone: (612) 940-9064
Type: Mailing
Fairview Lakes Medical Center, 5200, Fairview Boulevard, Wyoming, Chisago County, Minnesota, 55092, United States
WYOMING, MN 550928013
Phone: (651) 982-7000
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: 2021-12-13
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211213002489 | I | Physical Therapist In Private Practice | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 274 | 47 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 72 | 23 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 36 | 18 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 33 | 33 | $0 |
| 97530 | Therapy procedure using functional activities | 26 | 12 | $0 |
Insurance plans in this area (ZIP 55038)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | MN | |
| G A S T R O E N T E R O L O G Y | MN | |
| N E U R O S U R G E R Y | OH | |
| - | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | OR | |
| Cardiovascular Disease (Cardiology) | IL |
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