Stacy Anne Petersen, FNP-C in Costa Mesa, CA - Medicare Nurse Practitioner

Stacy Anne Petersen, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Costa Mesa, California. Her current practice location is 700 W 19th St, Costa Mesa, California. You can reach out to her office (for appointments etc.) via phone at (949) 645-4646.

Stacy Anne Petersen is licensed to practice in California (license number NP95007971) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1144719527.

Contact Information

	Stacy Anne Petersen, FNP-C
	700 W 19th St, Costa Mesa, CA 92627-3517
	(949) 645-4646
	Not Available

Map and Direction

Provider's Profile

Full Name	Stacy Anne Petersen
Gender	Female
Speciality	Nurse Practitioner - Family
Location	700 W 19th St, Costa Mesa, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1144719527
Provider Enumeration Date: 05/01/2018
Last Update Date: 02/26/2025

Medicare PECOS Information:

PECOS PAC ID: 0244589018
Enrollment ID: I20180828002028

Medical Identifiers

Medical identifiers for Stacy Anne Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144719527	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	NP95007971 (California)	Primary

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. Stacy Anne Petersen allows following entities to bill medicare on her behalf.

Entity Name	Leon Baginski M D Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518457704 PECOS PAC ID: 7315202629 Enrollment ID: O20180606003426

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. Stacy Anne Petersen 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
Stacy Anne Petersen, FNP-C 26791 Aliso Creek Rd, 1018, Laguna Niguel, CA 92677 Ph: (949) 991-4172	Stacy Anne Petersen, FNP-C 700 W 19th St, Costa Mesa, CA 92627-3517 Ph: (949) 645-4646

Reviews and Comments

Nurse Practitioner Nurses in Costa Mesa, CA

Alexandra Hutchison, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1530 Baker St Ste A, Costa Mesa, CA 92626 Phone: 714-559-5436
Judith Rivera, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 Anton Blvd Fl 11, Costa Mesa, CA 92626 Phone: 623-374-7774 Fax: 855-420-6361
Madison Lucas, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 150 Paularino Ave Ste D182, Costa Mesa, CA 92626 Phone: 866-300-7227
Mrs. Suzanne Clara Larkin, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1665 Scenic Ave, Costa Mesa, CA 92626 Phone: 714-436-4444
Rachel Renee Cliser, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 188 E 17th St Ste 101, Costa Mesa, CA 92627 Phone: 949-515-4548
Courtney Proctor, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 601 W 19th St, Costa Mesa, CA 92627 Phone: 714-922-4100
Susan Curtin, RN,MSN,PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2045 Meyer Pl, Bldg C, Costa Mesa, CA 92627 Phone: 949-515-6730 Fax: 949-515-6727

Stacy Anne Petersen, FNP-C - Medicare Nurse Practitioner in Costa Mesa, CA