MRS. STACY CRISTMAN THIEDEMAN PA-C
NPI 1154335800
Physician Assistant in Raleigh, NC

Active since July 28, 2006PECOS EnrolledAccepts Medicare Assignment
23 SUNNYBROOK RD, SUITE NUMBER 113, RALEIGH, NC 27610(919) 250-0580(919) 250-9939 Get Directions Write a Review

NPPES record last updated: April 13, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Stacy Cristman Thiedeman Pa-c NPPES

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

MRS. STACY CRISTMAN THIEDEMAN PA-C (NPI 1154335800) is an individual physician assistant in Raleigh, North Carolina, licensed in North Carolina (102584) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1998).

NPPES Registry Identity

NPI1154335800
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. STACY CRISTMAN THIEDEMANCredential: PA-C
Location Address23 SUNNYBROOK RD, SUITE NUMBER 113Raleigh, NC 27610-1855
Mailing Address2920 Highwoods BlvdRaleigh, NC 27604-0010 · (877) 498-4490
Fax(919) 250-9939
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateJuly 28, 2006
Last NPPES UpdateApril 13, 2021
NPPES CertifiedApril 13, 2021
NPI 1154335800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in NC · 102584
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

23 SUNNYBROOK RD, Raleigh, NC 27610

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mrs. Stacy Cristman Thiedeman Pa-c 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 ID2466477658
PECOS Enrollment IDI20051006000731
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27610 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
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 20

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

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
23 SUNNYBROOK RD
RALEIGH, NC 27610
Pediatrics (Pediatric Gastroenterology)
23 SUNNYBROOK RD
RALEIGH, NC 27610
Internal Medicine (Hematology & Oncology)
23 SUNNYBROOK RD
RALEIGH, NC 27610
Surgery (Pediatric Surgery)
23 SUNNYBROOK RD
RALEIGH, NC 27610
Counselor (Mental Health)
23 SUNNYBROOK RD
RALEIGH, NC 27610
Physician Assistant (Medical)
23 SUNNYBROOK RD, SUITE 220
RALEIGH, NC 27610
Internal Medicine (Hematology & Oncology)
23 SUNNYBROOK RD, SUITE 220
RALEIGH, NC 27610
Social Worker (Clinical)
23 SUNNYBROOK RD
RALEIGH, NC 27610

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Thiedeman's NPI number?

The NPI number for Stacy Thiedeman is 1154335800. It was assigned to this individual provider in the NPPES registry on July 28, 2006.

Where is Stacy Thiedeman located?

Stacy Thiedeman practices at 23 Sunnybrook Rd Suite Number 113, Raleigh, NC 27610. The listed phone number is (919) 250-0580.

What is Stacy Thiedeman's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Stacy Thiedeman enrolled in Medicare?

Yes. Stacy Thiedeman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Stacy Thiedeman accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and UnitedHealthcare list Stacy Thiedeman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stacy Thiedeman was last updated on April 13, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.