Stacey Kathryn Prudich, in Wake Forest, NC - Medicare Nurse Practitioner

Stacey Kathryn Prudich, is a medicare enrolled "Nurse Practitioner - Pediatrics" in Wake Forest, North Carolina. Her current practice location is 3000 Rogers Rd Ste 210, Wake Forest, North Carolina. You can reach out to her office (for appointments etc.) via phone at (919) 385-2120.

Stacey Kathryn Prudich is licensed to practice in North Carolina (license number 5017148) 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 1831806017.

Contact Information

	Stacey Kathryn Prudich,
	3000 Rogers Rd Ste 210, Wake Forest, NC 27587-5745
	(919) 385-2120
	Not Available

Map and Direction

Provider's Profile

Full Name	Stacey Kathryn Prudich
Gender	Female
Speciality	Nurse Practitioner - Pediatrics
Location	3000 Rogers Rd Ste 210, Wake Forest, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831806017
Provider Enumeration Date: 10/28/2022
Last Update Date: 10/29/2022

Medicare PECOS Information:

PECOS PAC ID: 1850763970
Enrollment ID: I20230217001012

Medical Identifiers

Medical identifiers for Stacey Kathryn Prudich such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831806017	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0200X	Nurse Practitioner - Pediatrics	PRUD-6TDQL (North Carolina)	Secondary
363LP0200X	Nurse Practitioner - Pediatrics	5017148 (North Carolina)	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. Stacey Kathryn Prudich allows following entities to bill medicare on her behalf.

Entity Name	Duke University Affiliated Physicians Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316975972 PECOS PAC ID: 3779489588 Enrollment ID: O20031211000642

Entity Name	Duke Health Integrated Practice Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205553369 PECOS PAC ID: 8325412737 Enrollment ID: O20230327002247

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. Stacey Kathryn Prudich 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
Stacey Kathryn Prudich, 1501 Bloomingdale Dr, Cary, NC 27511-5955 Ph: (919) 357-4713	Stacey Kathryn Prudich, 3000 Rogers Rd Ste 210, Wake Forest, NC 27587-5745 Ph: (919) 385-2120

Reviews and Comments

Nurse Practitioner Nurses in Wake Forest, NC

Ms. Reshana Lynne Dupree, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 833 Wake Forest Business Park Ste F, Wake Forest, NC 27587 Phone: 919-368-8839
Rebecca K Dallas, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1655 Wake Drive, Suite 101, Wake Forest, NC 27587 Phone: 919-556-4779 Fax: 919-556-5277
Caroline Wambui Kinge, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2204 Lower Lake Rd, Wake Forest, NC 27587 Phone: 919-630-3475
Deshah Jalen Johnson, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 833 Wake Forest Business Park Ste F, Wake Forest, NC 27587 Phone: 919-230-1419
Ms. Robin Nicole Godwin, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 620 Dr Calvin Jones Hwy, Wake Forest, NC 27587 Phone: 336-207-4731
Deborah Hupp, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 245 East Roosevelt Ave, Minuteclinic Diagnostic Of North Carolina, Wake Forest, NC 27587 Phone: 866-389-2727 Fax: 401-652-9787
Cherita Anders, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1655 Wake Dr Unit 101, Wake Forest, NC 27587 Phone: 195-564-7799 Fax: 919-556-5277

Stacey Kathryn Prudich, - Medicare Nurse Practitioner in Wake Forest, NC