PETER STASICA (NPI# 1063629368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063629368 |
| Entity Type | Individual |
| Full Name | PETER STASICA |
| Practice Address |
2200 University Ave W #114 Saint Paul MN 55114-1839 |
| Mailing Address |
1320 103rd Ln Nw Coon Rapids MN 55433-7115 |
| Practice Telephone | 6516445800 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2200 UNIVERSITY AVE W #114 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55114-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972500940 | Fairview Health Services | Durable Medical Equipment & Medical Supplies | 2200 University Ave W, Ste 110, Saint Paul, MN 55114-1839 | 2005-07-05 |
| 1417339474 | Kathryn Claus | Marriage & Family Therapist | 2200 University Ave W, Suite 160, Saint Paul, MN 55114-1839 | 2015-06-25 |
| 1760727077 | The Low Vision Store | Durable Medical Equipment & Medical Supplies | 2200 University Ave W, Suite 200, Saint Paul, MN 55114-1839 | 2012-11-28 |
| 1316256282 | Abby K Wiberg | Nurse Practitioner | 2200 University Ave W, Suite 120, Saint Paul, MN 55114-1839 | 2010-09-27 |
| 1295048080 | Nina Denise Guynn | Speech-Language Pathologist | 2200 University Ave W, Suite 140, Saint Paul, MN 55114-1839 | 2010-07-21 |
| 1578753927 | Labeigha Riser | Orthotic Fitter | 2200 University Ave W, Suite 114, Saint Paul, MN 55114-1839 | 2007-07-31 |
| 1497962708 | Scott Lynn Langston | Orthotist | 2200 University Ave W, #114, Saint Paul, MN 55114-1839 | 2007-05-17 |
| 1205043528 | David James Clark | Orthotic Fitter | 2200 University Ave W, #114, Saint Paul, MN 55114-1839 | 2007-05-17 |
| 1922215417 | Julie Ann Lien O'connell | Orthotist | 2200 University Ave W, #114, Saint Paul, MN 55114-1839 | 2007-05-16 |
| 1619198942 | David Benner Harris | Specialist | 2200 University Ave W, Suite 114, Saint Paul, MN 55114-1839 | 2007-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790205698 | Der Yang | Registered Nurse | 2356 University Ave W #220, Saint Paul, MN 55114 | 2017-06-21 |
| 1679949358 | Mallory Haglund | Counselor | 284 West Rocky Lane, Boulder, NV 55114 | 2015-08-17 |
| 1083090880 | Kayla Estenson | Marriage & Family Therapist | 2324 University Ave West, 120, St. Paul, MN 55114 | 2015-08-04 |
| 1184023772 | Preetanjali Thakur | Dentist | 2550 University Avenue West Suite 189s, St Paul, MN 55114 | 2014-08-19 |
| 1023426210 | Melanie Bayer Witthoft | Social Worker | 762 Transfer Road, 21, St. Paul, MN 55114 | 2014-07-31 |
| 1184046518 | Britni Kelley | Marriage & Family Therapist | 821 Raymond Ave Ste 325, Saint Paul, MN 55114 | 2014-01-21 |
| 1205257581 | Arti Kaul | Dentist | 808 Berry St, Apy 126, St Paul, MN 55114 | 2014-01-03 |
| 1588907109 | Jesus M Calvillo | Counselor | 821 Raymond Ave Ste 230, Saint Paul, MN 55114 | 2013-04-02 |
| 1154669414 | Caringhands Home Health Care Inc. | Home Health | 2233 University Ave West, Suite 330, St Paul, MN 55114 | 2013-01-22 |
| 1396021424 | The Avalon Charter School | Local Education Agency (LEA) | 700 Glendale Street, Saint Paul, MN 55114 | 2011-11-03 |
| Find all providers in zip 55114 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043538531 | Jill Prinsen | Prosthetist | 360 Sherman St, Suite 299, Saint Paul, MN 55102-2564 | 2010-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720318876 | Richard Clark Niessen Sr. | Prosthetist | 2025 East River Park Way, Shriners Hospitals for Children Twin Cities, Mpls, MN 55414-3604 | 2010-01-12 |
| 1386900272 | Kyle Robert Hamre | Prosthetist | 6600 France Ave S, Suite 162, Edina, MN 55435-1805 | 2012-04-05 |
| 1558691600 | Rebecca Lynn Born | Prosthetist | 2025 East River Parkway, Minneapolis, MN 55414-3604 | 2010-01-12 |
| 1699908483 | Steven Jahn | Prosthetist | 6600 France Ave S, Suite 162, Edina, MN 55435-1805 | 2009-08-27 |
| 1760637052 | Sarah Mahowald | Prosthetist | 1 Veterans Dr, Prosthetic Dept. (121), Minneapolis, MN 55417-2309 | 2008-12-01 |
| 1902013402 | Joseph Andrew Medvec | Prosthetist | 1 Veterans Dr, Prosthetics 121, Minneapolis, MN 55417-2309 | 2007-05-16 |
| 1013017813 | Chris Peter Boosalis | Prosthetist | 6600 France Ave S, Suite 162, Edina, MN 55435-1805 | 2006-09-22 |
| City | SAINT PAUL |
| Zip Code | 55114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.