Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Stacey Mackay

Individual provider Family Medicine Physician · NPI 1760469175

Stacey Mackay is registered under Family Practice in St Louis Park, Minnesota. Graduated from University of Virginia School of Medicine in 1992, 34 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
34
Trained at
University of Virginia School of Medicine
Licensed in
MN
In the registry since
2005
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Practice location Address checks out

3850 Park Nicollet Blvd Park Nicollet Clinic - Slp
St Louis Park, MN 55416
Phone: (952) 993-3025
Fax: (952) 993-1937
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2220 Riverside Ave, Minneapolis, MN 55454-1321 — (612) 371-1600

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 41342 (MN)

Record details

NPI number1760469175
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 28, 2005
Last updated in NPPESAugust 14, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Graduated 1992 (34 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients61
Services billed 69 a service is one billed item, such as a visit, a test or a procedure
Average patient age72

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Park Nicollet Clinic

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1773 clinicians in the practice; 12 are shown here.

Other providers in St Louis Park