MARY T SALLSTROM CPNP
NPI 1982031571
Nurse Practitioner - Pediatrics in Minneapolis, MN

Q: What is Mary Sallstrom's NPI number?

The NPI number for Mary Sallstrom is 1982031571. It was assigned to this individual provider in the NPPES registry on September 27, 2013.

Q: What is Mary Sallstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Mary Sallstrom was last updated on September 27, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 27, 2013PECOS Enrolled

81.72/100

CMS Quality Rating

2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 365-6777 Get Directions Write a Review

NPPES record last updated: September 27, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mary T Sallstrom Cpnp NPPES

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

MARY T SALLSTROM CPNP (NPI 1982031571) is an individual pediatrics provider in Minneapolis, Minnesota, licensed in Minnesota (R193258-8) and active in the NPI registry since September 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1982031571

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMARY T SALLSTROMCredential: CPNP

Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450

Mailing Address420 Delaware St Se, Mmc 366 (peds Bmt)Minneapolis, MN 55455-0341 · (612) 365-6777

Phone(612) 365-6777

Sole ProprietorNo

Enumeration DateSeptember 27, 2013

✔ NPI 1982031571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in MN · R193258-8

2450 RIVERSIDE AVE, Minneapolis, MN 55454

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, 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 (PECOS)

Mary T Sallstrom Cpnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 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.

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.

81.72/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

69.86

Promoting Interoperability

100

Improvement Activities

Cost

59.73

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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.

MICHELLE IRENE GRAY

Rehabilitation Practitioner