Individual provider Active NPI

Alexis Olivia Stambaugh, CRNP

  • Family Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1003681362
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP028719 Issued in PA
Practice address
2102 Harrisburg Pike
Lancaster, PA 17601-2644
Phone
(717) 544-9400
NPI assigned
Nov 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X SP028719 PA
Family Nurse Practitioner 363LF0000X SP028719 PA Primary

Addresses

Primary practice location

2102 Harrisburg Pike
Lancaster, PA 17601-2644

Mailing address

521 N President Ave
Lancaster, PA 17603-2601

Other names 1

  • Alexis Stoltzfus Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131001895 PA Practitioner - Nurse Practitioner 3375996895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General Medical GroupGroup PAC ID 0941103683, 590 clinicians

Practice addresses (Care Compare)

2104 Harrisburg Pike
Suite 200
Lancaster, PA 17601-2644
Phone (717) 544-3626

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group Current Accepting new patients
Lancaster General Medical Group CurrentSince Nov 28, 2023 Accepting new patients
Lancaster General Medical Group CurrentSince Nov 28, 2023 Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

554 N Duke St
Lancaster, PA 17602
Phone (717) 291-5863

2102 Harrisburg Pike
Lancaster, PA 17601
Phone (717) 544-3600

2108 Harrisburg Pike
Ste 100
Lancaster, PA 17601
Phone (717) 290-3900

2104 Harrisburg Pike
Ste 200
Lancaster, PA 17601
Phone (717) 290-3626

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

1001 Cornerstone Dr
#B
Mount Joy, PA 17552
Phone (717) 653-2929

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1003681362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N PRESIDENT AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176032601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 HARRISBURG PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMBAUGH",
        "first_name": "ALEXIS",
        "middle_name": "OLIVIA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "PA",
            "license": "SP028719",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "STOLTZFUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.