NICOLE ALTSTATT CNP
NPI 1982077061
Nurse Practitioner - Family in White Bear Lake, MN

Active since November 11, 2015PECOS EnrolledAccepts Medicare Assignment
4786 BANNING AVE, WHITE BEAR LAKE, MN 55110(612) 579-0597 Get Directions Write a Review

NPPES record last updated: February 13, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 13, 2019, Nov 11, 2015 (2 updates tracked since 2015).

About Nicole Altstatt Cnp NPPES

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

NICOLE ALTSTATT CNP (NPI 1982077061) is an individual family provider in White Bear Lake, Minnesota, licensed in Minnesota (CNP 4271) and active in the NPI registry since November 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Shoreview, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1982077061
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameNICOLE ALTSTATTCredential: CNP
Location Address4786 BANNING AVEWhite Bear Lake, MN 55110-3264
Mailing Address15830 Farnham Ave NHugo, MN 55038-9002 · (651) 503-7263
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateNovember 11, 2015
Last NPPES UpdateFebruary 13, 20192 updates tracked since enumeration
NPI 1982077061 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 · CNP 4271
Also ListedNurse PractitionerTaxonomy 363L00000X · License CNP 4271 (MN)
4786 BANNING AVE, White Bear Lake, MN 55110

Secondary Practice Location 1

Location 13800 Lexington Ave NShoreview, MN 55126-2916 · Phone (651) 486-0048

Accepted 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

Nicole Altstatt Cnp 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 ID42510570
PECOS Enrollment IDI20151204001426
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 2

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.
113 services93 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
27 services27 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55110 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 14

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
15 suppliers123 claims124 services$31.75 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
11 suppliers43 claims43 services$67.17 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
11 suppliers41 claims88 services$25.60 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
10 suppliers69 claims355 services$14.02 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
7 suppliers29 claims136 services$12.85 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
14 suppliers101 claims102 services$41.53 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110
Family Medicine
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110
Family Medicine
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110
Family Medicine
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110
Family Medicine
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110
Non-Pharmacy Dispensing Site
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110
Family Medicine
4786 BANNING AVE
WHITE BEAR LAKE, MN 55110

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 Nicole Altstatt's NPI number?

The NPI number for Nicole Altstatt is 1982077061. It was assigned to this individual provider in the NPPES registry on November 11, 2015.

Where is Nicole Altstatt located?

Nicole Altstatt practices at 4786 Banning Ave, White Bear Lake, MN 55110. The listed phone number is (612) 579-0597.

What is Nicole Altstatt's specialty?

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

Is Nicole Altstatt enrolled in Medicare?

Yes. Nicole Altstatt 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 Nicole Altstatt accept?

Health plans from Medica list Nicole Altstatt 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.

When was this NPI record last updated?

The NPPES record for Nicole Altstatt was last updated on February 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.