Kelly Stasa, CNP is a medicare enrolled "Nurse Practitioner - Family" in Blissfield, Michigan. She went to University Of Toledo College Of Medicine and graduated in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Promedica Central Corporation Of Michigan and her current practice location is
157 W Brooke Ln, Blissfield, Michigan. You can reach out to her office (for appointments etc.) via phone at
(517) 486-2411.
Kelly Stasa is licensed to practice in Michigan (license number 4704279024) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1912378134.
Provider's Profile
Full Name | Kelly Stasa |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 9 Years |
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Location | 157 W Brooke Ln, Blissfield, Michigan |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kelly Stasa attended and graduated from University Of Toledo College Of Medicine in 2015
NPI Data:
- NPI Number: 1912378134
- Provider Enumeration Date: 10/14/2015
- Last Update Date: 11/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 8224348768
- Enrollment ID: I20220207002403
Medical Identifiers
Medical identifiers for Kelly Stasa such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1912378134 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | COA.17942-NP (Ohio) | Secondary |
363LF0000X | Nurse Practitioner - Family | 4704279024 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Promedica Central Corporation Of Michigan | 7012902265 | 108 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Stasa allows following entities to bill medicare on her behalf.
Entity Name | Promedica Central Corporation Of Michigan |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1588624696 PECOS PAC ID: 7012902265 Enrollment ID: O20040416001163 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Stasa is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Stasa, CNP 13132 Neuroth Hwy, Jasper, MI 49248-9773 Ph: () - | Kelly Stasa, CNP 157 W Brooke Ln, Blissfield, MI 49228-8601 Ph: (517) 486-2411 |
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