DR. MARK STANLEY MELLSTROM (M.D.) – Family Medicine Physician, NPI 1346302106
Family Medicine Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MARK STANLEY MELLSTROM (M.D.)
20157 Icenic Trl
Lakeville, MN 550447708
Phone: (952) 469-3393
Fax: (952) 469-3399
Type: Location
200 1ST ST SW
ROCHESTER, MN 559050001
Phone: (651) 267-5000
Type: Mailing
Mayo Clinic Health System - Red Wing, 701, Hewitt Boulevard, Red Wing, Goodhue County, Minnesota, 55066, United States
RED WING, MN 550662848
Phone: (651) 267-5000
Fax: (651) 267-5964
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: 2018-11-27
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20101105001262 | I | Family Practice | MN | TBD |
| I20181127000980 | I | Family Practice | WI | 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 |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 133 | 80 | $0 |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 129 | 117 | $0 |
Insurance plans in this area (ZIP 55044)
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