Individual provider Active NPI

Stacy Ghiglieri, APRN, FNP-BC

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1053065623
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.024783 Issued in IL
Practice address
4215 Newburg Rd
Rockford, IL 61108-6479
Phone
(815) 988-8500
Fax
(815) 977-5956
NPI assigned
Feb 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.024783 IL Primary

Addresses

Primary practice location

4215 Newburg Rd
Rockford, IL 61108-6479

Mailing address

4215 Newburg Rd
Rockford, IL 61108-6479
Phone (815) 988-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220330002037 IL Practitioner - Nurse Practitioner 1557757531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bespoke Psychiatry 51 clinicians

Practice addresses (Care Compare)

1203 W Augusta Blvd
Chicago, IL 60642-4327
Phone (773) 248-2255

Merit-based Incentive Payment System (MIPS)

Final score
58.33 of 100Reported as group
Quality
41.25
Promoting interoperability
0
Improvement activities
40
Cost
69.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.024783ILMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1053065623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 NEWBURG RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086479",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 NEWBURG RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611086479",
            "telephone_number": "815-988-8500",
            "fax_number": "815-977-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHIGLIERI",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.