Mrs Staci Lynn Burleyson, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Salem, Illinois. She graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southern Illinois Healthcare Foundation, Inc. and her current practice location is
1275 Hawthorn Rd, Salem, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 548-4545.
Mrs Staci Lynn Burleyson is licensed to practice in Illinois (license number 209017646) 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 1487159943.
Physician's Profile
| Full Name | Mrs Staci Lynn Burleyson |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 6 Years |
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| Location | 1275 Hawthorn Rd, Salem, Illinois |
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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. |
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Medical Education and Training:
- Mrs Staci Lynn Burleyson graduated from medical school in 2018
NPI Data:
- NPI Number: 1487159943
- Provider Enumeration Date: 03/27/2018
- Last Update Date: 01/04/2022
Medicare PECOS Information:
- PECOS PAC ID: 5991043887
- Enrollment ID: I20190220000016
Medical Identifiers
Medical identifiers for Mrs Staci Lynn Burleyson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487159943 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | F03180485 (Illinois) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209017646 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southern Illinois Healthcare Foundation, Inc. | 1456256874 | 104 |
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 Staci Lynn Burleyson allows following entities to bill medicare on her behalf.
| Entity Name | Southern Illinois Healthcare Foundation, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013198712
PECOS PAC ID: 1456256874
Enrollment ID: O20031126000641 |
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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. Mrs Staci Lynn Burleyson 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 |
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Mrs Staci Lynn Burleyson, FNP-C
1275 Hawthorn Rd,
Salem, IL 62881-1028
Ph: (618) 548-4545 | Mrs Staci Lynn Burleyson, FNP-C
1275 Hawthorn Rd,
Salem, IL 62881-1028
Ph: (618) 548-4545 |
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