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STACY ANN CEDERSTROM FNP
NPI 1174079917
Nurse Practitioner - Family in Cass Lake, MN

Active since August 31, 2016PECOS EnrolledAccepts Medicare Assignment
425 7TH STREET NORTH EAST, CASS LAKE, MN 56633(218) 335-3200(218) 335-3300 Get Directions Write a Review

NPPES record last updated: May 22, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 22, 2023, Apr 8, 2019, Aug 31, 2016 (3 updates tracked since 2016).

About Stacy Ann Cederstrom Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY ANN CEDERSTROM FNP (NPI 1174079917) is an individual family provider in Cass Lake, Minnesota, licensed in Minnesota (CNP4566) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, is affiliated with Sanford Bemidji Medical Center, and maintains a secondary practice location in Hibbing.

NPPES Registry Identity

NPI1174079917
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSTACY ANN CEDERSTROMCredential: FNP
Location Address425 7TH STREET NORTH EASTCass Lake, MN 56633
Mailing Address425 7th Street North EastCass Lake, MN 56633 · (218) 335-3200 · Fax (218) 335-3300
Phone(218) 335-3200
Fax(218) 335-3300
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 31, 2016
Last NPPES UpdateMay 22, 20233 updates tracked since enumeration
NPPES CertifiedMay 22, 2023
✔ NPI 1174079917 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MN · CNP4566
Also ListedNurse PractitionerTaxonomy 363L00000X · License 4566 (MN)
425 7TH STREET NORTH EAST, Cass Lake, MN 56633
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Other Names 1

Former Name (1)Stacy Ann Tandeski

Secondary Practice Location 1

Location 11120 E 34th StHibbing, MN 55746-2909 · Phone (218) 362-7100 · Fax (218) 362-7131

Other Identifiers 2

OtherCNP4566MN · Fnp License
OtherMC3911028MN · Dnp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Stacy Ann Cederstrom Fnp 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.

PECOS PAC ID2365727336
PECOS Enrollment IDI20170315000559, I20170531001596
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
91 services46 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
22 services18 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
12 services12 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Sanford Bemidji Medical Center

Acute Care Hospitals · Bemidji, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240100
Location1300 Anne St NWBemidji, MN 56601 · Beltrami County
Emergency services Birthing friendly

Cass Lake Indian Health Services Hospital

Critical Access Hospitals · Cass Lake, MN
OwnershipGovernment - Federal
CMS Certification Number241358
Location425 7th Street NWCass Lake, MN 56633 · Cass County
Emergency services

Sanford Thief River Falls Medical Center

Critical Access Hospitals · Thief River Falls, MN
OwnershipVoluntary non-profit - Private
CMS Certification Number241381
Location3001 Sanford ParkwayThief River Falls, MN 56701 · Pennington County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56633 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers30 claims30 services$19.82 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers41 claims41 services$115.77 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Cederstrom's NPI number?

The NPI number for Stacy Cederstrom is 1174079917. It was assigned to this individual provider in the NPPES registry on August 31, 2016. The provider is also known as Stacy Ann Tandeski.

Where is Stacy Cederstrom located?

Stacy Cederstrom practices at 425 7th Street North East, Cass Lake, MN 56633. The listed phone number is (218) 335-3200.

What is Stacy Cederstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Stacy Cederstrom enrolled in Medicare?

Yes. Stacy Cederstrom 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.

What insurance does Stacy Cederstrom accept?

Health plans from Medica and Sanford Health Plan list Stacy Cederstrom 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.

Is Stacy Cederstrom affiliated with any hospitals?

According to CMS data, Stacy Cederstrom is affiliated with Sanford Bemidji Medical Center, Cass Lake Indian Health Services Hospital and Sanford Thief River Falls Medical Center.

When was this NPI record last updated?

The NPPES record for Stacy Cederstrom was last updated on May 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.