STACIE ANDERSON AGNP
NPI 1407695182
Nurse Practitioner - Gerontology in Sonoma, CA
About Stacie Anderson Agnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STACIE ANDERSON AGNP (NPI 1407695182) is an individual gerontology provider in Sonoma, California, licensed in California (95029378) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stacie Anderson Agnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stacie Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sonoma, CA 95476
- Reassigned Medicare billing, California enrollment
- 21 clinicians in this Medicare group
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 95476 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Stacie Anderson's NPI number?
The NPI number for Stacie Anderson is 1407695182. It was assigned to this individual provider in the NPPES registry on May 22, 2024.
Where is Stacie Anderson located?
Stacie Anderson practices at 19270 Sonoma Highway, Sonoma, CA 95476. The listed phone number is (707) 939-6070.
What is Stacie Anderson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.
Is Stacie Anderson enrolled in Medicare?
Yes. Stacie Anderson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stacie Anderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacie Anderson reassigns Medicare benefits to Sonoma Valley Community Health Center (Sonoma, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacie Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stacie Anderson was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Stacie Anderson, AGNP · NPI 1407695182
Gerontology physician in Sonoma, California. Individual provider, active in the CMS NPPES registry since May 22, 2024.
## Identity
- **NPI:** 1407695182 (Entity type: Individual)
- **Enumerated:** May 22, 2024
- **Primary specialty:** Nurse Practitioner - Gerontology · taxonomy 363LG0600X
- **State license:** 95029378 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 19270 SONOMA HIGHWAY, Sonoma, CA 95476
- **Phone:** (707) 939-6070
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Sonoma Valley Community Health Center (NPI 1770669715, Sonoma, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** May 22, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1407695182) · Data from the CMS NPPES public registry.