MS. STACY LEAH COLICH – Registered Dietitian, NPI 1760433437

MS. STACY LEAH COLICH is a healthcare provider. based in Cloquet, Minnesota. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold a License No. 1055 (MN). The NPI Number for MS. STACY LEAH COLICH is 1760433437

Main info

Female
42 Years Of Experience
Accepts Medicare Assignment
Name
MS. STACY LEAH COLICH
NPI
1760433437
Phone
(218) 879-4641
Address
512 SKYLINE BLVD
Enumeration Date
15 May 2006
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2188794641
Graduation Year
1984 (42 years ago)
PAC ID
3072833748
Group Practice PAC ID
0042129991
Professional Enrollment ID
I20150520000900
Address ID
MN557203787CL512XXBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

277 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in MN

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Provider Addresses for MS. STACY LEAH COLICH

  • Community Memorial Hospital, 512, Skyline Boulevard, Cloquet, Carlton County, Minnesota, 55720, United States

    COMMUNITY MEMORIAL HOSPITAL

    CLOQUET, MN 557201199

    Phone: (218) 879-4641

    Mailing address matches the actual address.

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: 2015-05-20

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
I20150520000900IRegistered Dietitian Or Nutrition ProfessionalMNTBD

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 55720)

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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: 0042129991View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMN
Nurse PractitionerMN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
N E U R O S U R G E R YMN
-MN
Family PracticeMN
General SurgeryMN

Reviews

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Frequently asked questions

What is MS. STACY LEAH COLICH's NPI number?
MS. STACY LEAH COLICH's NPI is 1760433437 — the number used across U.S. healthcare to identify this provider.
Is there an active status for MS. STACY LEAH COLICH?
For scheduling context, MS. STACY LEAH COLICH is shown as active in the registry.
What expertise is attributed to MS. STACY LEAH COLICH?
MS. STACY LEAH COLICH's specialty line reads Registered Dietitian. Clinical services aligned with this taxonomy classification.
Where in Minnesota is MS. STACY LEAH COLICH registered?
Use Cloquet, Minnesota as the headline location for MS. STACY LEAH COLICH here.
Can I trust this NPI listing for MS. STACY LEAH COLICH?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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