MRS. STACY LYN COMMODORE CRNA
NPI 1639409824
Nurse Anesthetist, Certified Registered in Morgantown, WV

Q: What is Stacy Commodore's NPI number?

The NPI number for Stacy Commodore is 1639409824. It was assigned to this individual provider in the NPPES registry on January 11, 2010.

Q: What is Stacy Commodore's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Stacy Commodore was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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 January 11, 2010Accepts Medicare Assignment

76.45/100

CMS Quality Rating

2000 MON HEALTH MEDICAL PARK DR STE 2001, MORGANTOWN, WV 26505(304) 720-8816(904) 494-6467 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 1, 2022, Dec 29, 2020, Jan 20, 2017 (3 updates tracked since 2017).

On this page

About Mrs. Stacy Lyn Commodore Crna NPPES

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

MRS. STACY LYN COMMODORE CRNA (NPI 1639409824) is an individual nurse anesthetist, certified registered in Morgantown, West Virginia, licensed in West Virginia (APRN62855) and active in the NPI registry since January 2010. She is a graduate of Other (2009).

NPPES Registry Identity

NPI1639409824

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameMRS. STACY LYN COMMODORECredential: CRNA

Location Address2000 MON HEALTH MEDICAL PARK DR STE 2001Morgantown, WV 26505-1167

Mailing AddressPo Box 3466Charleston, WV 25334-3466 · (304) 720-8816 · Fax (904) 494-6467

Phone(304) 720-8816

Fax(904) 494-6467

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateJanuary 11, 2010

Last NPPES UpdateOctober 21, 20253 updates tracked since enumeration

NPPES CertifiedOctober 21, 2025

✔ NPI 1639409824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in WV · APRN62855

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

2000 MON HEALTH MEDICAL PARK DR STE 2001, Morgantown, WV 26505

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Mrs. Stacy Lyn Commodore Crna 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 ID6709913122

PECOS Enrollment IDI20100416000135

Areas of Expertise CMS Part B claims 4

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.

Anesthesia for lens surgery 00142

Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.

607 services497 patients

Anesthesia for retinal surgery 00145

Anesthesia for retinal surgery involves using medications to numb your eye and surrounding area. This prevents pain and discomfort during the procedure. You may also receive medication to help you relax. The anesthesia can be local (just your eye) or general (you're asleep).

29 services28 patients

Anesthesia for other procedure on eye 00140

Anesthesia for an eye procedure involves administering medication to numb your eye and surrounding area, ensuring you feel no pain during the operation. It can be local (only the eye area) or general (whole body). It's safe and helps make the procedure comfortable.

18 services15 patients

Anesthesia for procedure on eyelid 00103

Anesthesia for an eyelid procedure helps ensure comfort and painlessness during the operation. It's typically a local anesthetic, applied to numb your eyelid and surrounding area. You'll likely be awake but won't feel any discomfort. It's a safe, routine part of many eye procedures.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26505 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

Most-billed visit code 99213

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.

76.45/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Promoting Interoperability

100

Improvement Activities

Cost

21.5

Reported Quality Measures

Anesthesiology Smoking Abstinence

69%111 patients3/55-star benchmark: 100%

Obstructive Sleep Apnea: Mitigation Strategies

91%1,571 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.

Other Providers at the Same Location NPPES 8

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

MIRANDA LYNN KING M.D.

Anesthesiology