DR. STACY ANN DONNELLY D.O
NPI 1629204284
Pediatrics in Greensburg, KY

Q: What is Stacy Donnelly's NPI number?

The NPI number for Stacy Donnelly is 1629204284. It was assigned to this individual provider in the NPPES registry on June 9, 2009.

Q: What is Stacy Donnelly's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Donnelly was last updated on December 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 09, 2009PECOS Enrolled

2680 CAMPBELLSVILLE RD, GREENSBURG, KY 42743(270) 299-2111(270) 299-2211 Get Directions Write a Review

NPPES record last updated: December 2, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Stacy Ann Donnelly D.o NPPES

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

DR. STACY ANN DONNELLY D.O (NPI 1629204284) is an individual pediatrics provider in Greensburg, Kentucky, licensed in Kentucky (04015) and active in the NPI registry since June 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629204284

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. STACY ANN DONNELLYCredential: D.O

Location Address2680 CAMPBELLSVILLE RDGreensburg, KY 42743-8898

Mailing AddressPo Box 1080Burkesville, KY 42717-1080 · (270) 858-6644 · Fax (270) 858-4027

Phone(270) 299-2111

Fax(270) 299-2211

Sole ProprietorNo

Enumeration DateJune 9, 2009

Last NPPES UpdateDecember 2, 2016

✔ NPI 1629204284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in KY · 04015

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

2680 CAMPBELLSVILLE RD, Greensburg, KY 42743

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Other Identifiers 2

Medicare PINK207140KY

Medicaid7100427790KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Sanford Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Stacy Ann Donnelly D.o 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 Reassignments

Medicare enrollment records show Stacy Donnelly reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mchs Hospitals, Inc.

538 mi

Mental Health (Including Community Mental Health Center)

2450 VINEYARD DR
Plover, WI 54467

Reassigned Medicare billing, Wisconsin enrollment
2,476 clinicians in this Medicare group

NPI 1386249894 (715) 342-0290

Marshfield Clinic Inc

565 mi

Clinic/Center

1000 N OAK AVE
Marshfield, WI 54449

Reassigned Medicare billing, Wisconsin enrollment
2,540 clinicians in this Medicare group

NPI 1952347981 (715) 387-5511

Memorial Hospital Inc

569 mi

Clinic/Center

N3708 RIVER AVE
Neillsville, WI 54456

Reassigned Medicare billing, Wisconsin enrollment
Also billed through NPI 1346239373 (Wisconsin)
1,440 clinicians in this Medicare group

NPI 1033701800 (715) 743-3101

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 42743 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

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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 5

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

SAMANTHA M ROUSE LPCC-S

Counselor (Mental Health)