DR. STACI HARWELL TEBBETTS OD
NPI 1417485715
Optometrist in Dawsonville, GA
About Dr. Staci Harwell Tebbetts Od NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. STACI HARWELL TEBBETTS OD (NPI 1417485715) is an individual optometrist in Dawsonville, Georgia, licensed in Georgia (OPT003012) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS and is a graduate of Southern College Of Optometry (2017).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Dr. Staci Harwell Tebbetts Od 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.
Medicare Billing Reassignments
3Medicare enrollment records show Staci Tebbetts reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Dawsonville, GA 30534
- Reassigned Medicare billing, Georgia enrollment
- 3 clinicians in this Medicare group
Braselton, GA 30517
- Reassigned Medicare billing, Georgia enrollment
- 7 clinicians in this Medicare group
Winder, GA 30680
- Reassigned Medicare billing, Georgia enrollment
- 9 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 30534 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Staci Tebbetts's NPI number?
The NPI number for Staci Tebbetts is 1417485715. It was assigned to this individual provider in the NPPES registry on May 31, 2017.
Where is Staci Tebbetts located?
Staci Tebbetts practices at 5983 Highway 53 E Ste 250, Dawsonville, GA 30534. The listed phone number is (706) 216-6595.
What is Staci Tebbetts's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Staci Tebbetts enrolled in Medicare?
Yes. Staci Tebbetts 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.
Which organizations bill Medicare for Staci Tebbetts's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Staci Tebbetts reassigns Medicare benefits to 3 organizations: North Georgia Family Eye Care, Inc. (Dawsonville, GA), Premier Vision Partners (Braselton, GA) and Winder Eye Care Center (Winder, GA). Each 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 Staci Tebbetts's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Staci Tebbetts accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee and 11 other insurers list Staci Tebbetts 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 Staci Tebbetts was last updated on September 27, 2023. 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.
# Dr. Staci Harwell Tebbetts, OD · NPI 1417485715
Optometrist provider in Dawsonville, Georgia. Individual provider, active in the CMS NPPES registry since May 31, 2017.
## Identity
- **NPI:** 1417485715 (Entity type: Individual)
- **Enumerated:** May 31, 2017
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **State license:** OPT003012 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 5983 HIGHWAY 53 E STE 250, Dawsonville, GA 30534-9516
- **Phone:** (706) 216-6595 · **Fax:** (706) 216-6594
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): North Georgia Family Eye Care, Inc. (NPI 1457738148, Dawsonville, GA); Premier Vision Partners (NPI 1376213165, Braselton, GA); Winder Eye Care Center (NPI 1154349041, Winder, GA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Southern College Of Optometry, class of 2017
## Record status
- **NPPES last updated:** September 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1417485715) · Data from the CMS NPPES public registry.