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STACI L SAMPO R.N.
NPI 1750427613
Nurse Practitioner - Pediatrics in Livermore, CA

Active since January 29, 2007Opted out of Medicare · through Feb 8, 2028
1133 E STANLEY BLVD, #103, LIVERMORE, CA 94550(925) 455-5050(925) 455-5084 Get Directions Write a Review

NPPES record last updated: April 2, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Staci L Sampo R.n. NPPES

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

STACI L SAMPO R.N. (NPI 1750427613) is an individual pediatrics provider in Livermore, California, licensed in California (10106) and active in the NPI registry since January 2007. She has opted out of Medicare through February 8, 2028.

NPPES Registry Identity

NPI1750427613
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameSTACI L SAMPOCredential: R.N.
Location Address1133 E STANLEY BLVD, #103Livermore, CA 94550-4200
Mailing Address1133 E Stanley Blvd, #103Livermore, CA 94550-4200 · (925) 455-5050 · Fax (925) 455-5084
Phone(925) 455-5050
Fax(925) 455-5084
Sole ProprietorNo
Enumeration DateJanuary 29, 2007
Last NPPES UpdateApril 2, 2013
✔ NPI 1750427613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in CA · 10106
1133 E STANLEY BLVD, Livermore, CA 94550
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Staci L Sampo R.n. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 8, 2024 through February 8, 2028.

Opt-Out Effective DateFebruary 8, 2024
Opt-Out In Effect ThroughFebruary 8, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94550 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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 18

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

YINETH ROCIO SMITH MD
Pediatrics
1133 E STANLEY BLVD, #103
LIVERMORE, CA 94550
Alameda County (925) 455-5050
STANFORD HEALTH CARE
Dermatology
1133 E STANLEY BLVD, SUITE 111
LIVERMORE, CA 94550
Alameda County (925) 373-4601
BAY AREA CARDIOLOGY MEDICAL GROUP
Internal Medicine (Interventional Cardiology)
1133 E STANLEY BLVD, SUITE 207
LIVERMORE, CA 94550
Alameda County (925) 294-9037
TRI-VALLEY FAMILY MEDICINE
Family Medicine
1133 E STANLEY BLVD, SUITE 201
LIVERMORE, CA 94550
Alameda County (925) 443-9000
KELLY MORRILL MSN, RN, FNP-BC, CEN
Nurse Practitioner (Family)
1133 E STANLEY BLVD
LIVERMORE, CA 94550
Alameda County (925) 373-4500
SCOTT DAVID EATON M.D.
Obstetrics & Gynecology (Obstetrics)
1133 E STANLEY BLVD, SUITE 205
LIVERMORE, CA 94550
Alameda County (925) 447-1010
JOHNETTE K LEIKAM MD
Pediatrics
1133 E STANLEY BLVD, #103
LIVERMORE, CA 94550
Alameda County (925) 455-5050
DR. LORENA H TAN MD
Family Medicine
1133 E STANLEY BLVD, SUITE 201
LIVERMORE, CA 94550
Alameda County (925) 443-9000

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 Staci Sampo's NPI number?

The NPI number for Staci Sampo is 1750427613. It was assigned to this individual provider in the NPPES registry on January 29, 2007.

Where is Staci Sampo located?

Staci Sampo practices at 1133 E Stanley Blvd #103, Livermore, CA 94550. The listed phone number is (925) 455-5050.

What is Staci Sampo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Staci Sampo enrolled in Medicare?

No. Staci Sampo has opted out of Medicare through February 8, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Staci Sampo was last updated on April 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.