Individual provider Active NPI

Lacey Etienne Neufeld, DNP, FNP-BC

  • Family Nurse Practitioner
  • Placerville, CA
National Provider Identifier
1053919258
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95016625 Issued in CA
Practice address
1095 Marshall Way # 100
Placerville, CA 95667-5722
Phone
(530) 626-2920
NPI assigned
Oct 12, 2020
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 95016625 CA Primary

Addresses

Primary practice location

1095 Marshall Way # 100
Placerville, CA 95667-5722

Mailing address

4793 Gresham Dr
El Dorado Hills, CA 95762-7700
Phone (530) 622-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210318001047 CA Practitioner - Nurse Practitioner 4789091703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marshall Medical CenterGroup PAC ID 7517875859, 168 clinicians

Practice addresses (Care Compare)

4201 Town Ctr Blvd
BLDG D
El Dorado Hills, CA 95762-7100
Phone (916) 905-6378

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95016625CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Marshall Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Marshall Medical Center Past Accepting new patients
Marshall Medical Center Past Accepting new patients

Locations

3581 Palmer Dr
Ste 602
Cameron Park, CA 95682
Phone (530) 626-2920

4201 Town Center Blvd
Bldg D
El Dorado Hills, CA 95762
Phone (530) 344-5400

1004 Fowler Way
Ste 4
Placerville, CA 95667
Phone (530) 626-9488

1095 Marshall Way
#100
Placerville, CA 95667
Phone (530) 626-2920

1095 Marshall Way
Ste 100
Placerville, CA 95667
Phone (530) 344-5470

1095 Marshall Way
Ste 201
Placerville, CA 95667
Phone (530) 344-5470

1100 Marshall Way
Placerville, CA 95667
Phone (530) 626-2601

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1053919258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4793 GRESHAM DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627700",
            "telephone_number": "530-622-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MARSHALL WAY # 100",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675722",
            "telephone_number": "530-626-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUFELD",
        "first_name": "LACEY",
        "middle_name": "ETIENNE",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.