STACI L ROSE APNP
NPI 1750611448
Nurse Practitioner in Fond Du Lac, WI

Q: What is Staci Rose's NPI number?

The NPI number for Staci Rose is 1750611448. It was assigned to this individual provider in the NPPES registry on January 4, 2010.

Q: What is Staci Rose's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Staci Rose was last updated on January 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since January 04, 2010PECOS EnrolledAccepts Medicare Assignment

210 WISCONSIN AMERICAN DR, FOND DU LAC, WI 54937(920) 907-7000 Get Directions Write a Review

NPPES record last updated: January 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2021, Mar 17, 2018, Nov 6, 2017 (3 updates tracked since 2017).

On this page

About Staci L Rose Apnp NPPES

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

STACI L ROSE APNP (NPI 1750611448) is an individual nurse practitioner in Fond Du Lac, Wisconsin, licensed in Wisconsin (3942-33) and active in the NPI registry since January 2010. She is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and maintains a secondary practice location in Princeton.

NPPES Registry Identity

NPI1750611448

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameSTACI L ROSECredential: APNP

Location Address210 WISCONSIN AMERICAN DRFond Du Lac, WI 54937-2999

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (920) 907-7025

Phone(920) 907-7000

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateJanuary 4, 2010

Last NPPES UpdateJanuary 8, 20243 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2024

✔ NPI 1750611448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 3942-33

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

210 WISCONSIN AMERICAN DR, Fond Du Lac, WI 54937

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Secondary Practice Location 1

Location 1502 W Water StPrinceton, WI 54968-9141 · Phone (920) 295-6432 · Fax (920) 295-4833

Other Identifiers 1

Medicaid1750611448WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Quartz.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

Staci L Rose Apnp 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 ID8426183666

PECOS Enrollment IDI20100312001009

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.

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520088

Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54937 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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 20

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

JEANETTE ROEHL APNP FNP

Nurse Practitioner