STACY L JOHNSON NP
NPI 1417907189
Nurse Practitioner - Family in Fort Wayne, IN

Active since May 11, 2006PECOS EnrolledAccepts Medicare Assignment
2510 E DUPONT RD STE 226, FORT WAYNE, IN 46825(260) 460-3100 Get Directions Write a Review

NPPES record last updated: November 20, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 20, 2023, Apr 30, 2018 (2 updates tracked since 2018).

About Stacy L Johnson Np NPPES

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

STACY L JOHNSON NP (NPI 1417907189) is an individual family provider in Fort Wayne, Indiana, licensed in Indiana (71002173A) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital Of Indiana, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1417907189
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSTACY L JOHNSONCredential: NP
Location Address2510 E DUPONT RD STE 226Fort Wayne, IN 46825-1603
Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateMay 11, 2006
Last NPPES UpdateNovember 20, 20232 updates tracked since enumeration
NPPES CertifiedNovember 20, 2023
NPI 1417907189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in IN · 71002173A
Also ListedNurse PractitionerTaxonomy 363L00000X · License 28140959A (IN)
2510 E DUPONT RD STE 226, Fort Wayne, IN 46825

Other Names 1

Former Name (1)Stacy L Sible Np

Other Identifiers 1

Medicaid200846660IN

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

Stacy L Johnson Np 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 ID7719986140
PECOS Enrollment IDI20061213000392
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
246 services179 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
151 services103 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
55 services36 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150017
Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County
Emergency services Birthing friendly

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150021
Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County
Emergency services Birthing friendly

Indiana University Health Ball Memorial Hospital

Acute Care Hospitals · Muncie, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150089
Location2401 University AveMuncie, IN 47303 · Delaware County
Emergency services Birthing friendly

Parkview Whitley Hospital

Acute Care Hospitals · Columbia City, IN
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150101
Location1260 E Sr 205Columbia City, IN 46725 · Whitley County
Emergency services Birthing friendly

Cameron Memorial Community Hospital Inc

Critical Access Hospitals · Angola, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151315
Location416 E Maumee StAngola, IN 46703 · Steuben County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46825 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Closing the Referral Loop: Receipt of Specialist Report
9%170 patients1/55-star benchmark: 87%
Controlling High Blood Pressure
39%381 patients2/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
48%3,233 patients2/55-star benchmark: 100%
e-Prescribing
97%2,993 patients4/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
78%453 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
16%1,171 patients1/55-star benchmark: 98%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 81% · 1,187 patients
Patients screened: 7% · 1,187 patients
9%718 patients1/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
1%1,196 patients1/55-star benchmark: 100%
Support Electronic Referral Loops By Receiving and Reconciling Health Information
23%241 patients1/55-star benchmark: 98%
Support Electronic Referral Loops By Sending Health Information
4%854 patients1/55-star benchmark: 97%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 0% · 453 patients
Patients totalRate: 1% · 453 patients
1%453 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers25 claims25 services$38.31 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
2 suppliers13 claims13 services$89.27 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
1 supplier12 claims35 services$36.29 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers14 claims14 services$19.51 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers23 claims128 services$2.20 avg. paid by Medicare
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
DME-Other DME · category DE001N
3 suppliers12 claims12 services$12.72 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Psychiatry & Neurology (Neurology)
2510 E DUPONT RD STE 226
FORT WAYNE, IN 46825
Nurse Practitioner (Family)
2510 E DUPONT RD STE 226
FORT WAYNE, IN 46825
Psychiatry & Neurology (Neurology)
2510 E DUPONT RD STE 226
FORT WAYNE, IN 46825

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 Johnson's NPI number?

The NPI number for Stacy Johnson is 1417907189. It was assigned to this individual provider in the NPPES registry on May 11, 2006. The provider is also known as Stacy L Sible Np.

Where is Stacy Johnson located?

Stacy Johnson practices at 2510 E Dupont Rd Ste 226, Fort Wayne, IN 46825. The listed phone number is (260) 460-3100.

What is Stacy Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Stacy Johnson enrolled in Medicare?

Yes. Stacy Johnson 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 Johnson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 1 other insurer list Stacy Johnson 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.

Is Stacy Johnson affiliated with any hospitals?

According to CMS data, Stacy Johnson is affiliated with Lutheran Hospital Of Indiana, Parkview Regional Medical Center, Indiana University Health Ball Memorial Hospital, Parkview Whitley Hospital and Cameron Memorial Community Hospital Inc.

When was this NPI record last updated?

The NPPES record for Stacy Johnson was last updated on November 20, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.