1. Home
  2. Directory
  3. California
  4. Sonoma
  5. Nurse Practitioner
  6. NPI Profile

STACIE ANDERSON AGNP
NPI 1407695182
Nurse Practitioner - Gerontology in Sonoma, CA

Active since May 22, 2024PECOS Enrolled
19270 SONOMA HIGHWAY, SONOMA, CA 95476(707) 939-6070 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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

NPI1407695182
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameSTACIE ANDERSONCredential: AGNP
Location Address19270 SONOMA HIGHWAYSonoma, CA 95476
Mailing Address911 Lakeville St # 116Petaluma, CA 94952-3329 · (509) 999-3989
Phone(707) 939-6070
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 22, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1407695182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in CA · 95029378
Also ListedNurse PractitionerTaxonomy 363L00000X · License 95029378 (CA)
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License 95029378 (CA)
19270 SONOMA HIGHWAY, Sonoma, CA 95476
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacie Anderson Agnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID648773069
PECOS Enrollment IDI20250911003769
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 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.

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 3

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

CLAUDIA GOVEA OCHOA REGISTER NURSE
Registered Nurse
19270 SONOMA HIGHWAY
SONOMA, CA 95476
Sonoma County (707) 939-6070
JENNIFER K DARBY
Nurse Practitioner (Family)
19270 SONOMA HIGHWAY
SONOMA, CA 95476
Sonoma County (707) 939-6070
JENNIFER HASA M.D.
Family Medicine
19270 SONOMA HIGHWAY
SONOMA, CA 95476
Sonoma County (707) 939-6070

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.

When was this NPI record last updated?

The NPPES record for Stacie Anderson was last updated on May 22, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.