LISA LARAINE STAFFORD NP
NPI 1144779497
Nurse Practitioner - Family in Santa Rosa, CA

Q: What is Lisa Stafford's NPI number?

The NPI number for Lisa Stafford is 1144779497. It was assigned to this individual provider in the NPPES registry on September 28, 2016.

Q: What is Lisa Stafford's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Stafford was last updated on December 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 28, 2016PECOS EnrolledAccepts Medicare Assignment

34 MARK WEST SPRINGS RD FL 3, SANTA ROSA, CA 95403(707) 573-5240(707) 573-5416 Get Directions Write a Review

NPPES record last updated: December 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 8, 2022, Oct 8, 2019, Apr 23, 2018 and 1 more (4 updates tracked since 2016).

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About Lisa Laraine Stafford Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA LARAINE STAFFORD NP (NPI 1144779497) is an individual family provider in Santa Rosa, California, licensed in California (2016013940) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Cruz, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1144779497

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameLISA LARAINE STAFFORDCredential: NP

Location Address34 MARK WEST SPRINGS RD FL 3Santa Rosa, CA 95403

Mailing Address325 Distel CirLos Altos, CA 94022-1408 · (707) 573-5240 · Fax (707) 573-5416

Phone(707) 573-5240

Fax(707) 573-5416

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateSeptember 28, 2016

Last NPPES UpdateDecember 8, 20224 updates tracked since enumeration

NPPES CertifiedDecember 8, 2022

✔ NPI 1144779497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 2016013940

34 MARK WEST SPRINGS RD FL 3, Santa Rosa, CA 95403

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Secondary Practice Location 1

Location 1250 Locust StSanta Cruz, CA 95060-3813 · Phone (831) 427-3500

Other Identifiers 1

OtherNP95004974CA · State Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa Laraine Stafford Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446682421

PECOS Enrollment IDI20191112003453

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Stafford reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc

37 mi

Internal Medicine

975 SERENO DRIVE
Vallejo, CA 94589

Reassigned Medicare billing, California enrollment
20,078 clinicians in this Medicare group

NPI 1336222397 (707) 651-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$109.88 typical visit price

range $21.02 – $153.40

Typical copayment $27.47 (range $5.25 – $38.35)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRANK CHIA-TANG HSU DO

Internal Medicine (Cardiovascular Disease)