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

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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 NameStacy Anne Petersen
GenderFemale
SpecialityNurse Practitioner - Family
Location700 W 19th St, Costa Mesa, California
Accepts Medicare AssignmentsMedicare 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: 05/01/2018
  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.
IdentifierTypeStateIssuer
1144719527NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse 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 NameSano Medical Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528144755
PECOS PAC ID: 6709853427
Enrollment ID: O20040913001054
Entity NameLeon Baginski, Md Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice Location Address
Stacy Anne Petersen, FNP-C
29 Terrace Cir,
Laguna Niguel, CA 92677-4112

Ph: (949) 514-5228		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
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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    
Yvette Alfelor Elpidio, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 3151 Airway Ave, T-3, Costa Mesa, CA 92626
Phone: 714-545-5550    Fax: 714-545-5748
Mrs. Suzanne Clara Larkin, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
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    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.