STACEY MACKAY
NPI 1760469175
Family Medicine in St Louis Park, MN

Q: What is Stacey Mackay's NPI number?

The NPI number for Stacey Mackay is 1760469175. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Q: What is Stacey Mackay's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Mackay was last updated on August 14, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since December 28, 2005PECOS EnrolledAccepts Medicare Assignment

3850 PARK NICOLLET BLVD, PARK NICOLLET CLINIC - SLP, ST LOUIS PARK, MN 55416(952) 993-3025(952) 993-1937 Get Directions Write a Review

NPPES record last updated: August 14, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Stacey Mackay NPPES

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

STACEY MACKAY (NPI 1760469175) is an individual family medicine provider in St Louis Park, Minnesota, licensed in Minnesota (41342) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1760469175

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSTACEY MACKAY

Location Address3850 PARK NICOLLET BLVD, PARK NICOLLET CLINIC - SLPSt Louis Park, MN 55416

Mailing Address6465 Wayzata Blvd, Ste 315St Louis Park, MN 55426-1728 · (952) 993-7169 · Fax (952) 993-0300

Phone(952) 993-3025

Fax(952) 993-1937

Sole ProprietorNo

Medical School CMSUniversity Of Virginia School Of MedicineGraduated 1992

Enumeration DateDecember 28, 2005

Last NPPES UpdateAugust 14, 2018

✔ NPI 1760469175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MN · 41342

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3850 PARK NICOLLET BLVD, St Louis Park, MN 55416

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Secondary Practice Location 1

Location 12220 Riverside AveMinneapolis, MN 55454-1321 · Phone (612) 371-1600

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.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

Stacey Mackay 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 ID4587677182

PECOS Enrollment IDI20060727000223

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

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 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.

45 services45 patients

Hospital Affiliations CMS Care Compare

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

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240053

Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 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.

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.

ELISABETH JEAN MCCLEAN MD

Family Medicine