NICOLE STALOCH NP
NPI 1134524242
Nurse Practitioner - Psychiatric/Mental Health in Fridley, MN
About Nicole Staloch Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE STALOCH NP (NPI 1134524242) is an individual psychiatric/mental health provider in Fridley, Minnesota, licensed in Minnesota (2825) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital, and maintains a secondary practice location in Saint Paul.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nicole Staloch Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Nicole Staloch reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fridley, MN 55432
- Reassigned Medicare billing, Minnesota enrollment
- Also billed through NPI 1912203365 (Minnesota)
- 3,733 clinicians in this Medicare group
Roseville, MN 55113
- Reassigned Medicare billing, Minnesota enrollment
- 2,361 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.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mercy Hospital
Acute Care Hospitals · Coon Rapids, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55432 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FRIDLEY, MN 55432
FRIDLEY, MN 55432
FRIDLEY, MN 55432
FRIDLEY, MN 55432
FRIDLEY, MN 55432
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 Nicole Staloch's NPI number?
The NPI number for Nicole Staloch is 1134524242. It was assigned to this individual provider in the NPPES registry on October 31, 2014.
Where is Nicole Staloch located?
Nicole Staloch practices at 520 Osborne Rd NE Ste 120, Fridley, MN 55432. The listed phone number is (763) 236-4300.
What is Nicole Staloch's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Nicole Staloch enrolled in Medicare?
Yes. Nicole Staloch is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Nicole Staloch's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Staloch reassigns Medicare benefits to 2 organizations: Allina Health System (Fridley, MN) and Healtheast Medical Research Institute (Roseville, MN). Each 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 Nicole Staloch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Nicole Staloch affiliated with any hospitals?
According to CMS data, Nicole Staloch is affiliated with Mercy Hospital.
When was this NPI record last updated?
The NPPES record for Nicole Staloch was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Nicole Staloch, NP · NPI 1134524242
Psychiatric/Mental Health physician in Fridley, Minnesota. Individual provider, active in the CMS NPPES registry since October 31, 2014.
## Identity
- **NPI:** 1134524242 (Entity type: Individual)
- **Enumerated:** October 31, 2014
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 2825 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 520 OSBORNE RD NE STE 120, Fridley, MN 55432-2718
- **Phone:** (763) 236-4300
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Allina Health System (NPI 1083197214, Fridley, MN); Healtheast Medical Research Institute (NPI 1053620187, Roseville, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** April 8, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1134524242) · Data from the CMS NPPES public registry.