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KATIE MICHELLE NYSTROM LICSW, MSW
NPI 1699355339
Social Worker in Crosby, MN

Active since April 08, 2021PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
320 EAST MAIN ST, CROSBY, MN 56441(218) 546-7000(218) 546-4400 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 29, 2021, Apr 8, 2021 (2 updates tracked since 2021).

About Katie Michelle Nystrom Licsw, Msw NPPES

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

KATIE MICHELLE NYSTROM LICSW, MSW (NPI 1699355339) is an individual social worker in Crosby, Minnesota, licensed in Minnesota (21668) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1699355339
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameKATIE MICHELLE NYSTROMCredential: LICSW, MSW
Location Address320 EAST MAIN STCrosby, MN 56441
Mailing Address320 East Main StCrosby, MN 56441 · (218) 546-7000 · Fax (218) 546-4400
Phone(218) 546-7000
Fax(218) 546-4400
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 8, 2021
Last NPPES UpdateNovember 29, 20212 updates tracked since enumeration
NPPES CertifiedNovember 29, 2021
✔ NPI 1699355339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MN · 21668
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
320 EAST MAIN ST, Crosby, MN 56441
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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

Katie Michelle Nystrom Licsw, Msw 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 ID8224438213
PECOS Enrollment IDI20210614000519
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.

Medicare Billing Reassignment

Medicare enrollment records show Katie Nystrom reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ametrine Mental Health PLLC
99 mi
Psychiatric/Mental Health
194 PROGRESS WAY
Spicer, MN 56288
  • Reassigned Medicare billing, Minnesota enrollment
  • 5 clinicians in this Medicare group
NPI 1902526437 (320) 640-2891

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

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.

MITCHELL J MIMBACH PA
Physician Assistant
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
ABBY L DINGMANN PA-C
Physician Assistant
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
MONICA K LARSON FNP-C
Nurse Practitioner (Family)
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
SHANNON M SICARD APRN, CRNA
Nurse Anesthetist, Certified Registered
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
BRITTA RAE PETERSON APRN, CRNA
Nurse Anesthetist, Certified Registered
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
EVAN KELLY MD
Surgery
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
BRADLEY E GUSTAFSON MD
Internal Medicine
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000
BRITTANY ROY CRNA
Nurse Anesthetist, Certified Registered
320 EAST MAIN ST
CROSBY, MN 56441
Crow Wing County (218) 546-7000

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 Katie Nystrom's NPI number?

The NPI number for Katie Nystrom is 1699355339. It was assigned to this individual provider in the NPPES registry on April 8, 2021.

Where is Katie Nystrom located?

Katie Nystrom practices at 320 East Main St, Crosby, MN 56441. The listed phone number is (218) 546-7000.

What is Katie Nystrom's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Is Katie Nystrom enrolled in Medicare?

Yes. Katie Nystrom 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 organization bills Medicare for Katie Nystrom's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katie Nystrom reassigns Medicare benefits to Ametrine Mental Health PLLC (Spicer, MN). 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 Katie Nystrom's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Katie Nystrom was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.