STACI E LOPEZ-VERGARA CPNP
NPI 1407191323
Nurse Practitioner - Pediatrics in Fort Worth, TX

Q: What is Staci Lopez-vergara's NPI number?

The NPI number for Staci Lopez-vergara is 1407191323. It was assigned to this individual provider in the NPPES registry on December 4, 2012. The provider is also known as Staci Dickard Pnp.

Q: What is Staci Lopez-vergara's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Active since December 04, 2012PECOS Enrolled

9840 N BEACH ST, FORT WORTH, TX 76244(817) 431-3898(817) 379-1161 Get Directions Write a Review

NPPES record last updated: May 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 14, 2024, May 2, 2024, Apr 27, 2021 and 1 more (4 updates tracked since 2021).

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About Staci E Lopez-vergara Cpnp NPPES

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

STACI E LOPEZ-VERGARA CPNP (NPI 1407191323) is an individual pediatrics provider in Fort Worth, Texas, licensed in Texas (AP122615) and active in the NPI registry since December 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407191323

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameSTACI E LOPEZ-VERGARACredential: CPNP

Location Address9840 N BEACH STFort Worth, TX 76244-6184

Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-1855 · Fax (682) 885-1396

Phone(817) 431-3898

Fax(817) 379-1161

Sole ProprietorNo

Enumeration DateDecember 4, 2012

Last NPPES UpdateMay 14, 20244 updates tracked since enumeration

NPPES CertifiedMay 14, 2024

✔ NPI 1407191323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LP0200X

Licenses✔ Licensed in TX · AP122615✔ Licensed in TX · 755740

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License AP122615 (TX)

9840 N BEACH ST, Fort Worth, TX 76244

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Other Names 1

Former Name (1)Staci Dickard Pnp

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Staci E Lopez-vergara Cpnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 76244 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

$87.20 typical visit price

range $56.47 – $171.07

Typical copayment $21.80 (range $14.11 – $42.76)

Most-billed visit code 99203

Established Patient

$99.68 typical visit price

range $18.18 – $139.68

Typical copayment $24.92 (range $4.54 – $34.92)

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 9

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

MRS. LARA LAINE LAWRENCE RN, MNSC, APRN, CPNP

Physician Assistant