STACI LEIGH CLUTTER PA-C
NPI 1679054464
Physician Assistant - Surgical in Lima, OH

Q: What is Staci Clutter's NPI number?

The NPI number for Staci Clutter is 1679054464. It was assigned to this individual provider in the NPPES registry on August 28, 2018. The provider is also known as Staci Leigh Braun.

Q: What is Staci Clutter's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Staci Clutter was last updated on February 21, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 28, 2018PECOS EnrolledAccepts Medicare Assignment

801 MEDICAL DR STE A, LIMA, OH 45804(419) 222-6622(419) 224-0015 Get Directions Write a Review

NPPES record last updated: February 21, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 21, 2019, Aug 28, 2018 (2 updates tracked since 2018).

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About Staci Leigh Clutter Pa-c NPPES

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

STACI LEIGH CLUTTER PA-C (NPI 1679054464) is an individual surgical provider in Lima, Ohio and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, is affiliated with Mercer County Joint Township Community Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1679054464

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameSTACI LEIGH CLUTTERCredential: PA-C

Location Address801 MEDICAL DR STE ALima, OH 45804-4030

Mailing Address1008 Fleck AveCelina, OH 45822-8738 · (419) 953-3910

Phone(419) 222-6622

Fax(419) 224-0015

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateAugust 28, 2018

Last NPPES UpdateFebruary 21, 20192 updates tracked since enumeration

✔ NPI 1679054464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Also ListedPhysician AssistantTaxonomy 363A00000X

801 MEDICAL DR STE A, Lima, OH 45804

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Other Names 1

Former Name (1)Staci Leigh Braun

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

Staci Leigh Clutter Pa-c 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 ID6709139629

PECOS Enrollment IDI20181023002280

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.

Areas of Expertise CMS Part B claims

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

12 services12 patients

Hospital Affiliations CMS Care Compare

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

Mercer County Joint Township Community Hospital

Acute Care Hospitals · Coldwater, OH

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number360058

Location800 West Main StreetColdwater, OH 45828 · Mercer County

Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims

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

Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment L1820

DME-Orthotic Devices · category DF011N

1 supplier27 claims27 services$113.95 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 20

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

MRS. BETH A WARNECKE PAC

Physician Assistant (Surgical)