Stacy Ronquillo, NP in Portland, OR - Medicare Nurse Practitioner

Stacy Ronquillo, NP is a medicare enrolled "Nurse Practitioner - Family" in Portland, Oregon. Her current practice location is 9455 Sw 80th Ave, Portland, 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
	9455 Sw 80th Ave, Portland, OR 97223-8966
	(503) 208-4610
	(503) 447-2700

Map and Direction

Provider's Profile

Full Name	Stacy Ronquillo
Gender	Female
Speciality	Nurse Practitioner - Family
Location	9455 Sw 80th Ave, Portland, 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: 09/12/2024

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
363LA2100X	Nurse Practitioner - Acute Care	10012143 (Oregon)	Secondary
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 Po Box 2411, Tualatin, OR 97062-2411 Ph: (503) 208-4610	Stacy Ronquillo, NP 9455 Sw 80th Ave, Portland, OR 97223-8966 Ph: (503) 208-4610

Reviews and Comments

Nurse Practitioner Nurses in Portland, OR

Mrs. Anjalee Nix Rowe, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-3988
Ms. Susan Irene Smith, RN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239 Phone: 971-202-5500 Fax: 971-202-5555
Iva Juric, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239 Phone: 503-494-4808
Ms. Jessica A Dudley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-746-1575
Summer Morgan Massina, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209 Phone: 503-525-0090
Dr. Jeffery Wise, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1834 Nw 25th Ave Apt 504, Portland, OR 97210 Phone: 971-354-9242
A'lissa Richards, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12121 E Burnside St, Portland, OR 97216 Phone: 971-361-7700

Stacy Ronquillo, NP - Medicare Nurse Practitioner in Portland, OR