STACY DAVIDSON CPNP-AC
NPI 1467028209
Nurse Practitioner - Pediatrics in Sacramento, CA
About Stacy Davidson Cpnp-ac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STACY DAVIDSON CPNP-AC (NPI 1467028209) is an individual pediatrics provider in Sacramento, California, licensed in California (95003179) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stacy Davidson Cpnp-ac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stacy Davidson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Sacramento, CA 95817
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Regents Of The Univ Of Ca
- 2,570 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 95817 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SACRAMENTO, CA 95817
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 Davidson's NPI number?
The NPI number for Stacy Davidson is 1467028209. It was assigned to this individual provider in the NPPES registry on June 2, 2021. The provider is also known as Stacy Broich Rn.
Where is Stacy Davidson located?
Stacy Davidson practices at 2315 Stockton Blvd, Sacramento, CA 95817. The listed phone number is (916) 734-9200.
What is Stacy Davidson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Stacy Davidson enrolled in Medicare?
Yes. Stacy Davidson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stacy Davidson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stacy Davidson reassigns Medicare benefits to Regents Of The University Of Ca (Sacramento, 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 Stacy Davidson'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 Stacy Davidson was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Stacy Davidson, CPNP-AC · NPI 1467028209
Pediatrics physician in Sacramento, California. Individual provider, active in the CMS NPPES registry since June 2, 2021.
## Identity
- **NPI:** 1467028209 (Entity type: Individual)
- **Enumerated:** June 2, 2021
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 95003179 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2315 STOCKTON BLVD, Sacramento, CA 95817-2201
- **Phone:** (916) 734-9200
## 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:** Regents Of The University Of Ca (NPI 1063405074, Sacramento, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 13, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1467028209) · Data from the CMS NPPES public registry.