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STACEY KATHRYN PRUDICH
NPI 1831806017
Nurse Practitioner - Pediatrics in Wake Forest, NC

Active since October 28, 2022PECOS Enrolled
3000 ROGERS RD STE 210, WAKE FOREST, NC 27587(919) 385-2120 Get Directions Write a Review

NPPES record last updated: October 29, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Stacey Kathryn Prudich NPPES

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

STACEY KATHRYN PRUDICH (NPI 1831806017) is an individual pediatrics provider in Wake Forest, North Carolina, licensed in North Carolina (5017148) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1831806017
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameSTACEY KATHRYN PRUDICH
Location Address3000 ROGERS RD STE 210Wake Forest, NC 27587-5745
Mailing Address1501 Bloomingdale DrCary, NC 27511-5955 · (919) 357-4713
Phone(919) 385-2120
Sole ProprietorNo
Enumeration DateOctober 28, 2022
Last NPPES UpdateOctober 29, 2022
NPPES CertifiedOctober 29, 2022
✔ NPI 1831806017 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
Licenses✔ Licensed in NC · 5017148✔ Licensed in NC · PRUD-6TDQL
3000 ROGERS RD STE 210, Wake Forest, NC 27587
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey Kathryn Prudich is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Stacey Prudich reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Duke University Affiliated Physicians, Inc.
Same address
Emergency Medicine
3000 ROGERS RD STE 100
Wake Forest, NC 27587
  • Reassigned Medicare billing, North Carolina enrollment
  • 636 clinicians in this Medicare group
NPI 1649140963 (919) 385-1601
Duke Health Integrated Practice, Inc
9.9 mi
Gastroenterology
3480 WAKE FOREST RD STE 500
Raleigh, NC 27609
  • Reassigned Medicare billing, North Carolina enrollment
  • 3,671 clinicians in this Medicare group
NPI 1780374884 (919) 862-5075

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 27587 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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 5

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

DR. CHRISTIAN NECHYBA M.D.
Pediatrics
3000 ROGERS RD STE 210
WAKE FOREST, NC 27587
Wake County (919) 385-2120
DR. SARA N TABRIZI M.D.
Pediatrics
3000 ROGERS RD STE 210
WAKE FOREST, NC 27587
Wake County (919) 385-2120
ELZIA RENA BROUSSARD MD
Pediatrics
3000 ROGERS RD STE 210
WAKE FOREST, NC 27587
Wake County (919) 385-2120
ERIKA COLLINS CRAVANAS M.D.
Pediatrics
3000 ROGERS RD STE 210
WAKE FOREST, NC 27587
Wake County (919) 385-2120
DR. NICOLE CAMERON MD
Pediatrics
3000 ROGERS RD STE 210
WAKE FOREST, NC 27587
Wake County (919) 385-2120

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 Stacey Prudich's NPI number?

The NPI number for Stacey Prudich is 1831806017. It was assigned to this individual provider in the NPPES registry on October 28, 2022.

Where is Stacey Prudich located?

Stacey Prudich practices at 3000 Rogers Rd Ste 210, Wake Forest, NC 27587. The listed phone number is (919) 385-2120.

What is Stacey Prudich's specialty?

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

Is Stacey Prudich enrolled in Medicare?

Yes. Stacey Prudich is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Stacey Prudich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacey Prudich reassigns Medicare benefits to 2 organizations: Duke University Affiliated Physicians, Inc. (Wake Forest, NC) and Duke Health Integrated Practice, Inc (Raleigh, NC). 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 Stacey Prudich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stacey Prudich accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Cigna Healthcare list Stacey Prudich as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Stacey Prudich was last updated on October 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.