STACY ANN CEDERSTROM FNP
NPI 1174079917
Nurse Practitioner - Family in Cass Lake, MN
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
Specialties & Licenses 2
Other Names 1
Secondary Practice Location 1
Other Identifiers 2
Accepted Insurance
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
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.
Medicare Billing Reassignments
4Medicare enrollment records show Stacy Cederstrom reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Bemidji, MN 56601
- Reassigned Medicare billing, Minnesota enrollment
- Medicare enrollment name: Sanford Health Of Northern Minnesota
- 607 clinicians in this Medicare group
Park Rapids, MN 56470
- Reassigned Medicare billing, Minnesota enrollment
- 66 clinicians in this Medicare group
Hibbing, MN 55746
- Reassigned Medicare billing, Minnesota enrollment
- 513 clinicians in this Medicare group
Thief River Falls, MN 56701
- Reassigned Medicare billing, Minnesota enrollment
- Also billed through NPI 1043218753 (Minnesota)
- 219 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 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.
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, MNCass Lake Indian Health Services Hospital
Critical Access Hospitals · Cass Lake, MNSanford Thief River Falls Medical Center
Critical Access Hospitals · Thief River Falls, MNPhysician 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.
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.
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.
Which organizations bill Medicare for Stacy Cederstrom's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacy Cederstrom reassigns Medicare benefits to 4 organizations: North Country Health Services (Bemidji, MN), St Joseph's Area Health Services (Park Rapids, MN), St. Luke's Hospital Of Duluth (Hibbing, MN) and Sanford Health Network North (Thief River Falls, 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 Stacy Cederstrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Stacy Cederstrom accept?
Health plans from Sanford Health Plan and Security 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.
# Stacy Ann Cederstrom, FNP · NPI 1174079917
Family physician in Cass Lake, Minnesota. Individual provider, active in the CMS NPPES registry since August 31, 2016.
## Identity
- **NPI:** 1174079917 (Entity type: Individual)
- **Enumerated:** August 31, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** CNP4566 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 425 7TH STREET NORTH EAST, Cass Lake, MN 56633
- **Phone:** (218) 335-3200 · **Fax:** (218) 335-3300
## 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:** 4 organizations under Medicare reassignment (form CMS-855R): North Country Health Services (NPI 1417006255, Bemidji, MN); St Joseph's Area Health Services (NPI 1013460864, Park Rapids, MN); St. Luke's Hospital Of Duluth (NPI 1427000512, Hibbing, MN); Sanford Health Network North (NPI 1386047355, Thief River Falls, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** May 22, 2023
- **Other identifiers:** Other CNP4566 (MN); Other MC3911028 (MN)
---
Source: [NPI Profile](https://npiprofile.com/npi/1174079917) · Data from the CMS NPPES public registry.