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

Q: 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.

Q: What is Stacey Prudich's specialty?

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

Q: 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 3 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 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: August 02, 2026.

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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

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

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.

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