MYSTICAL ROSE OBSTETRICS AND GYNECOLOGY
NPI 1851521231
Obstetrics & Gynecology in Fallbrook, CA

Q: What is Mystical Rose Obstetrics And Gynecology's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Active since July 21, 2009CLIA 05D2078398 · Waiver

577 E ELDER ST STE K, FALLBROOK, CA 92028(760) 983-4024(760) 723-9010 Get Directions Write a Review

NPPES record last updated: December 21, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 21, 2021, Apr 13, 2018, Feb 23, 2018 (3 updates tracked since 2018).

On this page

About Mystical Rose Obstetrics And Gynecology NPPES

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

MYSTICAL ROSE OBSTETRICS AND GYNECOLOGY (NPI 1851521231) is a healthcare organization registered as an obstetrics & gynecology in Fallbrook, California and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through May 26, 2028, maintains a secondary practice location in Fallbrook, and lists Shilo Stigen, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1851521231

Entity TypeOrganization

Primary Taxonomy207V00000X

Legal Business NameMYSTICAL ROSE OBSTETRICS AND GYNECOLOGY

Location Address577 E ELDER ST STE KFallbrook, CA 92028-3079

Mailing Address577 E Elder St Ste KFallbrook, CA 92028-3079 · (760) 983-4024 · Fax (760) 723-9010

Phone(760) 983-4024

Fax(760) 723-9010

Organization SubpartNo

Authorized OfficialShilo StigenChief Financial Officer · (619) 318-4798

Enumeration DateJuly 21, 2009

Last NPPES UpdateDecember 21, 20213 updates tracked since enumeration

NPPES CertifiedDecember 21, 2021

✔ NPI 1851521231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

577 E ELDER ST STE K, Fallbrook, CA 92028

Open in Google Maps ↗

Secondary Practice Location 1

Location 1521 E Elder St, Suite 206Fallbrook, CA 92028-3081 · Phone (760) 983-4024 · Fax (760) 723-9010

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mystical Rose Obstetrics And Gynecology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mystical Rose Obstetrics And Gynecology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Theresa Stigen, M.D.

Obstetrics/Gynecology

NPI 1851572986

577 E ELDER ST STE K
Fallbrook, CA 92028

(760) 983-4024

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2078398

Mystical Rose Obstetrics And Gynecology · Fallbrook, CA

Active · expires May 26, 2028

CLIA Number05D2078398

Laboratory TypePhysician Office

Certificate Effective DateMay 27, 2026

Certificate Expiration DateMay 26, 2028

Laboratory DirectorTheresa L. Stigen

Laboratory Phone(760) 983-4024

Laboratory LocationMystical Rose Obstetrics And Gynecology577 E Elder St, Ste K, Fallbrook, CA 92028

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Mystical Rose Obstetrics And Gynecology's NPI number?

The NPI number for Mystical Rose Obstetrics And Gynecology is 1851521231. It was assigned to this organization in the NPPES registry on July 21, 2009.

Where is Mystical Rose Obstetrics And Gynecology located?

Mystical Rose Obstetrics And Gynecology is located at 577 E Elder St Ste K, Fallbrook, CA 92028. The listed phone number is (760) 983-4024.

What is Mystical Rose Obstetrics And Gynecology's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Mystical Rose Obstetrics And Gynecology enrolled in Medicare?

Yes. Mystical Rose Obstetrics And Gynecology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mystical Rose Obstetrics And Gynecology?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Obstetrics/Gynecology) reassigns their Medicare billing to Mystical Rose Obstetrics And Gynecology. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mystical Rose Obstetrics And Gynecology hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2078398) is associated with this NPI, valid through May 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mystical Rose Obstetrics And Gynecology was last updated on December 21, 2021. 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.