STACEY MARIE TALLO
NPI 1659151157
Nurse Practitioner - Family in Georgetown, SC

Q: What is Stacey Tallo's NPI number?

The NPI number for Stacey Tallo is 1659151157. It was assigned to this individual provider in the NPPES registry on October 2, 2023.

Q: What is Stacey Tallo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Stacey Tallo was last updated on January 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 October 02, 2023PECOS EnrolledAccepts Medicare Assignment

1068 N FRASER ST, GEORGETOWN, SC 29440(843) 545-7200 Get Directions Write a Review

NPPES record last updated: January 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 8, 2025, Oct 2, 2023 (2 updates tracked since 2023).

On this page

About Stacey Marie Tallo NPPES

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

STACEY MARIE TALLO (NPI 1659151157) is an individual family provider in Georgetown, South Carolina, licensed in South Carolina (28666) and active in the NPI registry since October 2023. She is enrolled in Medicare PECOS, is affiliated with Tidelands Georgetown Memorial Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1659151157

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSTACEY MARIE TALLO

Location Address1068 N FRASER STGeorgetown, SC 29440-2849

Mailing Address1068 N Fraser StGeorgetown, SC 29440-2849 · (317) 496-3143

Phone(843) 545-7200

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateOctober 2, 2023

Last NPPES UpdateJanuary 8, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2025

✔ NPI 1659151157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in SC · 28666

1068 N FRASER ST, Georgetown, SC 29440

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, UnitedHealthcare.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

Stacey Marie Tallo 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 ID9830613330

PECOS Enrollment IDI20250407000523

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.

Hospital Affiliations CMS Care Compare

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

Tidelands Georgetown Memorial Hospital

Acute Care Hospitals · Georgetown, SC

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number420020

Location606 Black River Rd Drawer 1718Georgetown, SC 29440 · Georgetown County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29440 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

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.

STEPHEN JAMES PIGMAN MSPAS

Physician Assistant