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 10 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 | 10 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. |
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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 |
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| 1912378134 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 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 |
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| Promedica Central Corporation Of Michigan | 7012902265 | 109 |
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 |
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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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