STATERA LLC
NPI 1689172751
Clinic/Center - Primary Care in Dubuque, IA
About Statera Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STATERA LLC (NPI 1689172751) is a healthcare organization registered as a primary care in Dubuque, Iowa and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through February 13, 2028 and lists Nicole Lee Hutchison, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Statera Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Statera LLC, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 16D2144293
Statera, LLC · Dubuque, IAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Statera LLC's NPI number?
The NPI number for Statera LLC is 1689172751. It was assigned to this organization in the NPPES registry on January 24, 2018.
Where is Statera LLC located?
Statera LLC is located at 3375 Lake Ridge Drive, Dubuque, IA 52003. The listed phone number is (563) 580-0243.
What is Statera LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Statera LLC enrolled in Medicare?
Yes. Statera LLC is registered in the Medicare PECOS enrollment system.
When is Statera LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Iowa, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Statera LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 4 Medicare specialties reassign their Medicare billing to Statera LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Chiropractic (1) and Family Practice (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Statera LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 16D2144293) is associated with this NPI, valid through February 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Statera LLC was last updated on January 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Statera Llc · NPI 1689172751
Primary Care organization in Dubuque, Iowa. Organization record, active in the CMS NPPES registry since January 24, 2018.
## Identity
- **NPI:** 1689172751 (Entity type: Organization)
- **Enumerated:** January 24, 2018
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Nicole Hutchison, OWNER
## Practice location
- **Address:** 3375 LAKE RIDGE DRIVE, Dubuque, IA 52003
- **Phone:** (563) 580-0243
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Iowa, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 6 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Chiropractic (1), Family Practice (1); 5 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 24, 2018
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1689172751) · Data from the CMS NPPES public registry.