Mrs Stacie Lynne Ebersold, MSN, NP-C in Philadelphia, PA

Mrs Stacie Lynne Ebersold, MSN, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Philadelphia, Pennsylvania. She graduated from nursing school in 2019 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Suburban Geriatrics Ii Pc and her current practice location is 100 S Juniper St Fl 3, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (866) 849-0692.

Mrs Stacie Lynne Ebersold is licensed to practice in Pennsylvania (license number SP020581) 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 1750943155.

Contact Information

	Mrs Stacie Lynne Ebersold, MSN, NP-C
	100 S Juniper St Fl 3, Philadelphia, PA 19107-1316
	(866) 849-0692
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Stacie Lynne Ebersold
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	100 S Juniper St Fl 3, Philadelphia, Pennsylvania
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:

Mrs Stacie Lynne Ebersold graduated from nursing school in 2019

NPI Data:

NPI Number: 1750943155
Provider Enumeration Date: 07/05/2019
Last Update Date: 11/12/2025

Medicare PECOS Information:

PECOS PAC ID: 3375976483
Enrollment ID: I20191204000078

Medical Identifiers

Medical identifiers for Mrs Stacie Lynne Ebersold such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750943155	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	APRN11041685 (Florida)	Secondary
363LF0000X	Nurse Practitioner - Family	SP020581 (Pennsylvania)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Suburban Geriatrics Ii Pc	9537552419	88

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. Mrs Stacie Lynne Ebersold allows following entities to bill medicare on her behalf.

Entity Name	Suburban Geriatric's, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1679594808 PECOS PAC ID: 4486551371 Enrollment ID: O20031218000064

Entity Name	Wellspan Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669770004 PECOS PAC ID: 1951213115 Enrollment ID: O20040220000815

Entity Name	Suburban Geriatrics Ii Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073273363 PECOS PAC ID: 9537552419 Enrollment ID: O20220217001836

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. Mrs Stacie Lynne Ebersold 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
Mrs Stacie Lynne Ebersold, MSN, NP-C Po Box 211699, Eagan, MN 55121-3699 Ph: () -	Mrs Stacie Lynne Ebersold, MSN, NP-C 100 S Juniper St Fl 3, Philadelphia, PA 19107-1316 Ph: (866) 849-0692

Reviews and Comments

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Mrs Stacie Lynne Ebersold, MSN, NP-C - Medicare Nurse Practitioner in Philadelphia, PA