DR. STACY WALLIN DNP, APRN, NNP-BC
NPI 1104225580
Nurse Practitioner - Neonatal in Minot, ND
About Dr. Stacy Wallin Dnp, Aprn, Nnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STACY WALLIN DNP, APRN, NNP-BC (NPI 1104225580) is an individual neonatal provider in Minot, North Dakota, licensed in North Dakota (R29613) and active in the NPI registry since August 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Minot.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Stacy Wallin Dnp, Aprn, Nnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stacy Wallin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Turtle Lake, ND 58575
- Reassigned Medicare billing, North Dakota enrollment
- 616 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 58701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINOT, ND 58701
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stacy Wallin's NPI number?
The NPI number for Stacy Wallin is 1104225580. It was assigned to this individual provider in the NPPES registry on August 21, 2014.
Where is Stacy Wallin located?
Stacy Wallin practices at 2305 37th Ave SW, Minot, ND 58701. The listed phone number is (701) 418-8000.
What is Stacy Wallin's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.
Is Stacy Wallin enrolled in Medicare?
Yes. Stacy Wallin is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stacy Wallin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacy Wallin reassigns Medicare benefits to St. Alexius Medical Center (Turtle Lake, ND). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacy Wallin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Stacy Wallin accept?
Health plans from Blue Cross Blue Shield of North Dakota and Sanford Health Plan list Stacy Wallin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Stacy Wallin was last updated on September 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Stacy Wallin, DNP, APRN, NNP-BC · NPI 1104225580
Neonatal physician in Minot, North Dakota. Individual provider, active in the CMS NPPES registry since August 21, 2014.
## Identity
- **NPI:** 1104225580 (Entity type: Individual)
- **Enumerated:** August 21, 2014
- **Primary specialty:** Nurse Practitioner - Neonatal · taxonomy 363LN0000X
- **State license:** R29613 (North Dakota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2305 37TH AVE SW, Minot, ND 58701-7669
- **Phone:** (701) 418-8000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St. Alexius Medical Center (NPI 1013961820, Turtle Lake, ND), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104225580) · Data from the CMS NPPES public registry.