STACY MARIE SMITH (MPAS, PA-C) – Physician Assistant, NPI 1356668123
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
Provider Addresses for STACY MARIE SMITH (MPAS, PA-C)
2025 SLOAN PL
SUITE 35
SAINT PAUL, MN 551172007
Phone: (651) 772-1572
Fax: (651) 772-1889
Type: Mailing
4786 BANNING AVE
WHITE BEAR LAKE, MN 551103264
Phone: (651) 426-6402
Fax: (651) 429-3402
Type: Location
1233 34TH ST NW
BEMIDJI, MN 566015112
Phone: (218) 333-5000
Type: Location
PO BOX 5074
SIOUX FALLS, SD 571175074
Phone:
Type: Mailing
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: 2010-07-15
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 |
|---|---|---|---|---|
| I20100715000283 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 181 | 122 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 98 | 72 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 11 | 11 | $0 |
Insurance plans in this area (ZIP 55117)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| A N E S T H E S I O L O G Y | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Diagnostic Radiology | MN | |
| N E U R O L O G Y | MN | |
| - | ND | |
| - | MN | |
| O P T O M E T R Y | SD | |
| Nurse Practitioner | ND |
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