MRS. STACIE M MALLON FNP-C
NPI 1720614456
Nurse Practitioner - Family in Woodward, IA

Active since March 13, 2020PECOS Enrolled
30865 130TH CT, WOODWARD, IA 50276(515) 490-9739 Get Directions Write a Review

NPPES record last updated: March 13, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mrs. Stacie M Mallon Fnp-c NPPES

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

MRS. STACIE M MALLON FNP-C (NPI 1720614456) is an individual family provider in Woodward, Iowa, licensed in Iowa (A157443) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1720614456
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. STACIE M MALLONCredential: FNP-C
Location Address30865 130TH CTWoodward, IA 50276-6209
Mailing AddressPo Box 276Slater, IA 50244-0276 · (515) 490-9739
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMarch 13, 2020
NPPES CertifiedMarch 13, 2020
✔ NPI 1720614456 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 IA · A157443
30865 130TH CT, Woodward, IA 50276

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Stacie M Mallon Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688056153
PECOS Enrollment IDI20260310002555, I20260410000321
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

2

Medicare enrollment records show Stacie Mallon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

552 mi
Family Medicine
500 KIRTS BLVD, SUITE 200
Troy, MI 48084
  • Reassigned Medicare billing, Iowa enrollment
  • 27 clinicians in this Medicare group
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Iowa, Montana and Oregon enrollments
  • 202 clinicians in this Medicare group

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 50276 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
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $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.

Frequently 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 Stacie Mallon's NPI number?

The NPI number for Stacie Mallon is 1720614456. It was assigned to this individual provider in the NPPES registry on March 13, 2020.

Where is Stacie Mallon located?

Stacie Mallon practices at 30865 130th Ct, Woodward, IA 50276. The listed phone number is (515) 490-9739.

What is Stacie Mallon's specialty?

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

Is Stacie Mallon enrolled in Medicare?

Yes. Stacie Mallon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Stacie Mallon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacie Mallon reassigns Medicare benefits to 2 organizations: Vpa PC (Troy, MI) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Stacie Mallon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Stacie Mallon was last updated on March 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.