STACEY DIMITT MD
NPI 1508151978
Family Medicine in Grants, NM

Q: What is Stacey Dimitt's NPI number?

The NPI number for Stacey Dimitt is 1508151978. It was assigned to this individual provider in the NPPES registry on June 14, 2011.

Q: What is Stacey Dimitt's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Stacey Dimitt was last updated on September 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since June 14, 2011PECOS Enrolled

1423 E ROOSEVELT AVE, GRANTS, NM 87020(505) 287-6500(505) 287-5393 Get Directions Write a Review

NPPES record last updated: September 2, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 2, 2020, Aug 29, 2018, May 8, 2018 (3 updates tracked since 2018).

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About Stacey Dimitt Md NPPES

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

STACEY DIMITT MD (NPI 1508151978) is an individual family medicine provider in Grants, New Mexico, licensed in Kansas (7613) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1508151978

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameSTACEY DIMITTCredential: MD

Location Address1423 E ROOSEVELT AVEGrants, NM 87020-2245

Mailing Address1423 E Roosevelt AveGrants, NM 87020-2245 · (505) 287-6500 · Fax (505) 287-5393

Phone(505) 287-6500

Fax(505) 287-5393

Sole ProprietorNo

Enumeration DateJune 14, 2011

Last NPPES UpdateSeptember 2, 20203 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2020

✔ NPI 1508151978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in KS · 7613

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1423 E ROOSEVELT AVE, Grants, NM 87020

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Secondary Practice Locations 2

Location 1119 E Parliament StSmith Center, KS 66967-3015 · Phone (316) 962-3030

Location 2921 E Highway 36Smith Center, KS 66967 · Phone (785) 282-6834 · Fax (785) 282-3793

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey Dimitt Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Stacey Dimitt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cibola General Hospital Corporation

0.2 mi

Critical Access

1016 E ROOSEVELT AVE
Grants, NM 87020

Reassigned Medicare billing, New Mexico enrollment
144 clinicians in this Medicare group

NPI 1780677039 (505) 287-5300

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 87020 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

$84.79 typical visit price

range $54.26 – $166.80

Typical copayment $21.19 (range $13.56 – $41.70)

Most-billed visit code 99203

Established Patient

$96.38 typical visit price

range $17.00 – $135.35

Typical copayment $24.09 (range $4.25 – $33.83)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers18 claims20 services$50.53 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers33 claims36 services$105.81 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 13

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

LEANNA M GAISTHIA COMMUNITY HEALTH WOR

Community Health Worker