MR. JOHN JOSEPH STACY MLTDSW, CAC-1
NPI 1912035627
Social Worker - Clinical in Ann Arbor, MI
About Mr. John Joseph Stacy Mltdsw, Cac-1 NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JOHN JOSEPH STACY MLTDSW, CAC-1 (NPI 1912035627) is an individual clinical provider in Ann Arbor, Michigan, licensed in Michigan (6801087738) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2006).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. John Joseph Stacy Mltdsw, Cac-1 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.
Medicare Billing Reassignment
Medicare enrollment records show John Stacy reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Toledo, OH 43614
- Reassigned Medicare billing, Ohio enrollment
- 263 clinicians in this Medicare group
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 48108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
ANN ARBOR, MI 48108
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 John Stacy's NPI number?
The NPI number for John Stacy is 1912035627. It was assigned to this individual provider in the NPPES registry on March 2, 2007.
Where is John Stacy located?
John Stacy practices at 2140 E Ellsworth Rd, Ann Arbor, MI 48108. The listed phone number is (734) 222-9501.
What is John Stacy's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is John Stacy enrolled in Medicare?
Yes. John Stacy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for John Stacy's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Stacy reassigns Medicare benefits to State Of Ohio Office Of Budget And Management State Accounting (Toledo, OH). The 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 John Stacy's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does John Stacy accept?
Health plans from Anthem Blue Cross and Blue Shield list John Stacy 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 John Stacy was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Mr. John Joseph Stacy, MLTDSW, CAC-1 · NPI 1912035627
Clinical provider in Ann Arbor, Michigan. Individual provider, active in the CMS NPPES registry since March 2, 2007.
## Identity
- **NPI:** 1912035627 (Entity type: Individual)
- **Enumerated:** March 2, 2007
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 6801087738 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 2140 E ELLSWORTH RD, Ann Arbor, MI 48108-2552
- **Phone:** (734) 222-9501 · **Fax:** (734) 971-2487
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** State Of Ohio Office Of Budget And Management State Accounting (NPI 1083688097, Toledo, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2006
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1912035627) · Data from the CMS NPPES public registry.