Stacy Ronquillo, NP in Lake Oswego, OR - Medicare Nurse Practitioner

Stacy Ronquillo, NP is a medicare enrolled "Nurse Practitioner - Family" in Lake Oswego, Oregon. Her current practice location is 525 3rd St Ste 200, Lake Oswego, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 208-4610.

Stacy Ronquillo is licensed to practice in Oregon (license number 10012143) 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 1811603079.

Contact Information

	Stacy Ronquillo, NP
	525 3rd St Ste 200, Lake Oswego, OR 97034-3082
	(503) 208-4610
	Not Available

Map and Direction

Provider's Profile

Full Name	Stacy Ronquillo
Gender	Female
Speciality	Nurse Practitioner - Family
Location	525 3rd St Ste 200, Lake Oswego, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1811603079
Provider Enumeration Date: 01/30/2023
Last Update Date: 04/01/2024

Medicare PECOS Information:

PECOS PAC ID: 4284096785
Enrollment ID: I20230816000057

Medical Identifiers

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

Identifier	Type	State	Issuer
1811603079	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	10012143 (Oregon)	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 Ronquillo allows following entities to bill medicare on her behalf.

Entity Name	Nisha Jackson Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1124499124 PECOS PAC ID: 6305147745 Enrollment ID: O20151209000878

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 Ronquillo 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 Ronquillo, NP 525 3rd St Ste 200, Lake Oswego, OR 97034-3082 Ph: (503) 208-4610	Stacy Ronquillo, NP 525 3rd St Ste 200, Lake Oswego, OR 97034-3082 Ph: (503) 208-4610

Reviews and Comments

Nurse Practitioner Nurses in Lake Oswego, OR

Susan Ranae Battle, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5 Centerpointe Dr, Lake Oswego, OR 97035 Phone: 541-214-6301 Fax: 855-510-1784
Krisa Fenton, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5 Centerpointe Dr Ste 600, Lake Oswego, OR 97035 Phone: 615-465-9443
Miss Amanda Magdalena Kinder, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4103 Mercantile Dr, Lake Oswego, OR 97035 Phone: 503-850-9940
Mrs. Amanda L Swinehart, NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5299 Lakeview Blvd, Lake Oswego, OR 97035 Phone: 740-215-1612
Dr. Kristine Susan White, DNP, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 14523 Westlake Dr Ste 25, Lake Oswego, OR 97035 Phone: 503-854-7160 Fax: 503-886-8961
Anthony Hernandez, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5 Centerpointe Dr Ste 600, Lake Oswego, OR 97035 Phone: 503-603-7355
Tierney Newman, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4004 Kruse Way Pl Ste 300, Lake Oswego, OR 97035 Phone: 503-216-1500

Stacy Ronquillo, NP - Medicare Nurse Practitioner in Lake Oswego, OR